Safety Goals Questionnaire Our Goal: Everyone Goes Home SAFE…Every Day! How can we help you meet your Safety Goals? Please answer the following questions so that we can better determine how we can help you manage your workplace safety program. Name* First Last Phone*Email* Company Name*Are you confident that your organization is OSHA compliant every day?*YesNoAre you prepared to pass a wall-to-wall inspection should an OSHA inspector knock on your door unexpectedly?*YesNoAre your incident and DART rates rising?*YesNoAre your workers compensation premiums rising?*YesNoCould you use some assistance developing a best in class safety program?*YesNoDo you feel like your safety program promotes sufficient two-way communication between workers and management?*YesNoDo you strive to improve safety, but workers complain that management does not address their concerns?*YesNoDo you know your workers' perception of management's attitude towards safety?*YesNoWould you be interested in receiving email communications from us?* Yes No What is your preferred method of contact?* Email Phone Text CAPTCHA This iframe contains the logic required to handle Ajax powered Gravity Forms.