Shiftwork Services - www.shiftwork.co.nz

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* 1. What is your role? 

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* 2. What industry sector do you work in?

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* 3. Which of the following does your employer offer to promote the safety and well-being of shiftworkers?

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* 4. How concerned are you about fatigue management in your workplace?

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* 5. Please briefly describe any accidents or incidents that you have noted in your workplace where you think fatigue has been a factor?  This could include, not paying attention, falling asleep, forgetting things, dropping items, slips, trips and falls, motor vehicle accidents or making poor decisions.

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* 6. Shiftwork and sleep deprivation can affect physical and mental health as well as safety. Which of the following have you experienced in the past 12 months? Tick as many as you like.

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* 7. A good roster is important to ensure a safe, healthy and productive  workforce. In your opinion how well does the roster meet your expectations? 

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* 8. What would improve safety, health and  productivity of shiftworkers where you work?  Tick as many as you like.

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* 9. To discuss shiftworker wellbeing please complete your details below. 

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* 10. I would like to be kept informed

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