BTF School/Site Health and Safety Assessment

General Information

Thank you for completing this assessment. It should be completed when continuing or new safety circumstances require its submission. Issues will be sent to the District for correction. Names will be redacted and be confidential.

Question Title

* 1. For which School/Site are you reporting?

Question Title

* 2. What is today's date?

Date

Question Title

* 3. Please provide the name(s) and personal email(s) of the teacher(s) that are completing this assessment.

Teacher 1 Name

Teacher 1 Email

Teacher 2 Name

Teacher 2 Email

Teacher 3 Name

Teacher 3 Email