Housing - New Employee Job Hazard Survey

Please fill out a survey form for each of your existing employees and new employees (At the time of hire) that you supervise. EHS uses the survey to determine training needs and potential exposure hazards to determine whether a job hazard assessment (JHA) is needed for an employee or job description for a group of employees.

Please read each question carefully and contact EHS if you have any questions.

This form by should be filled out by supervisors on the behalf of all employees under their supervision.

Enter the position title as it appears on the employees job description.

Please note; this section is used by EHS to determine the need for work-site additional job hazard assessment.

EHS uses this information to create a training plan for the employee on this survey.

Please check all job responsibilities that are applicable to this employee. Check box if the answer is "Yes", leave blank if the answer is "No".

Do you have any notes or comments that you need to share with EHS? Please type them in the box below.

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