Your COVID-19 Risk Profile Survey

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* 1. What industry do you work in?

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* 2. What Company do you work for?
Note: answer this if you would like organisational / cohort level summary.

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* 3. How would you classify your primary work movements?

Fixed Office or Site-based

Transient / Field Based

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* 4. How many SHARED surfaces (touch-points) do you estimate you contact during an average day? (Criteria below)

	Personal / None	2-5	6-10	11-20	21-50	50+
At Home	At Home Personal / None	At Home 2-5	At Home 6-10	At Home 11-20	At Home 21-50	At Home 50+
Commute to Work	Commute to Work Personal / None	Commute to Work 2-5	Commute to Work 6-10	Commute to Work 11-20	Commute to Work 21-50	Commute to Work 50+
At Work	At Work Personal / None	At Work 2-5	At Work 6-10	At Work 11-20	At Work 21-50	At Work 50+
Commute from Work	Commute from Work Personal / None	Commute from Work 2-5	Commute from Work 6-10	Commute from Work 11-20	Commute from Work 21-50	Commute from Work 50+

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SHARED Criteria

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* 5. Tell us a bit about the nature of your SPACES in a typical day where you are in close-contact with groups of people? (Criteria below)

	Alone / No Close Contact	2-5 People	6-10 People	11-25 People	50+ Gathering
At Home	At Home Alone / No Close Contact	At Home 2-5 People	At Home 6-10 People	At Home 11-25 People	At Home 50+ Gathering
Commute to Work	Commute to Work Alone / No Close Contact	Commute to Work 2-5 People	Commute to Work 6-10 People	Commute to Work 11-25 People	Commute to Work 50+ Gathering
At Work	At Work Alone / No Close Contact	At Work 2-5 People	At Work 6-10 People	At Work 11-25 People	At Work 50+ Gathering
Commute from Work	Commute from Work Alone / No Close Contact	Commute from Work 2-5 People	Commute from Work 6-10 People	Commute from Work 11-25 People	Commute from Work 50+ Gathering

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SPACES Criteria

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* 6. What measures have you put in place to address hygiene requirements:

Signage

Training for staff

Additional wash stations

Hand sanitizer

Antibacterial wipes

Other (please specify)

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* 7. What measures have you implemented to comply with social distancing requirements?

Working from home

Separation of teams (A and B)

Changes to workplace layout

Training for staff

Increased supervision

Other (please specify)

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* 8. What other steps have you taken to address COVID-19?

Risk assessment

Policy issued

Training for staff

Modified working arrangements

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* 9. Please provide your contact details if you would like feedback.

Name

Company

Email Address

Phone Number

Your COVID-19 Risk Profile

Question Title

* 1. What industry do you work in?

Question Title

* 2. What Company do you work for?Note: answer this if you would like organisational / cohort level summary.

Question Title

* 3. How would you classify your primary work movements?

Question Title

* 4. How many SHARED surfaces (touch-points) do you estimate you contact during an average day? (Criteria below)

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SHARED Criteria

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* 5. Tell us a bit about the nature of your SPACES in a typical day where you are in close-contact with groups of people? (Criteria below)

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SPACES Criteria

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* 6. What measures have you put in place to address hygiene requirements:

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* 7. What measures have you implemented to comply with social distancing requirements?

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* 8. What other steps have you taken to address COVID-19?

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* 9. Please provide your contact details if you would like feedback.

* 2. What Company do you work for?
Note: answer this if you would like organisational / cohort level summary.