* 1. What type of laboratory do you work in?

* 2. Do you regularly wear the following PPE in your laboratory?

  Yes No N/A
Lab Coat
Gloves
Safety Glasses/Goggles
Long Pants
Closed Toe Shoes

* 3. Do your lab mates, including your PI, regularly wear the following PPE in your laboratory?

  Yes No N/A
Lab Coat
Gloves
Safety Glasses/Goggles
Long Pants
Closed Toe Shoes

* 4. Has your laboratory completed and posted its Laboratory Assessment Tool and Chemical Hygiene Plan (LATCH)?

* 5. Does your laboratory take steps to prevent food and drink from being consumed in the laboratory?

* 6. Are you up to date with all safety training requirements?

* 7. Is your laboratory’s emergency contact information posted, up-to-date and reflective of who should be contacted in a 24-hour emergency situation?

* 8. Do you know where your laboratory emergency equipment is located?

  Yes No N/A
Fire extinguisher
Eye wash
Overhead emergency shower
Chemical spill kit

* 9. Who is responsible for testing/inspecting your laboratory emergency equipment?

  Lab Staff EH&S Facilities/Other
Fire extinguisher
Eye wash
Overhead emergency shower
Chemical spill kit

* 10. If you answered NO to any of the above questions, would you be interested in…

  Yes No
EH&S visiting your lab to discuss possible safety program improvements?
EH&S attending your upcoming lab meeting to discuss possible safety program improvements?
EH&S providing additional training to your laboratory personnel?

* 11. If you have requested an EH&S follow-up in Question 10, please provide some additional information in order for us to arrange a meeting:

* 12. Do have any additional comments, concerns, or questions about safety at Columbia
University?

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