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Workwell Survey

Have you been targeted for a Workwell audit?
 
Please fill out the following information and click submit.
 
First Name*
Last Name*
Job Title
Company Name*
Email Address*
Do you know why you have been targeted for a Workwell audit?* Frequent visits from the Ministry of Labour
NEER surcharge
High frequency of claims
Critical accidents
Other
If you selected "other" for the above question, please explain.
Would you like to receive more information regarding Workwell audits and how to improve your score?* Yes No
Number of employees
What is the date of your audit?*
How many audits have you had in the past?*
What preparation techniques will you be implementing before your audit?

 
* Indicates field is required.