Sandy Smith, Managing Editor
Occupational Hazards
1300 E. Ninth St.
Cleveland, OH 44114-1503
Safest Companies Questionnaire
Company name:
Headquarters address:
Industry/Product(s):
Number of employees/sites:
Lost-time injury rate for your company and your industry's average:
Please name any other safety or environmental awards received by your company:
Number of EHS professionals at your company:
Company/management philosophy regarding safety:
Please offer at least one example that is indicative of management's dedication to safe production:
How are employees encouraged to participate in the safety process? (Please offer at least two examples.):
What are some of the key elements of your occupational safety and health program?
Please check all that apply. Does your company have:
____ safety committee(s)
____ ergonomics program
____ an incentive/motivation program
____ employee wellness program
____ a formal training/mentoring program
____safety auditing program
Are there unique elements to the safety process at your company? If so, please describe those efforts here.
Can you share an example or examples of where your company's safety policies and procedures go above and beyond OSHA standards? Above ANSI voluntary standards? Above accepted industry standards?
Why does your company deserve to be named one of America's Safest Companies by Occupational Hazards magazine?
Please include any additional information here, or enclose it with the completed questionnaire
Name __________________________________________________________________
Title ___________________________________________________________________
Telephone and e-mail ____________________________________________________