safety before profits Link to Community Shares of Greater Milwaukee

WisCOSH Web Visitor Feedback

WisCOSH Web Guestbook

If you would like to post a comment about this website, your workplace safety and/or health issues or make a sugestion on how WisCOSH can improve this website to better serve you, please visit : Add your comment here.

WisCOSH Web Feedack Form

We here at WisCOSH want to help you, and to do that effectively we need to know about your workplace. What kind of work do you do, in what kind of conditions, for how long, and what kind of injuries are most often sustained on the job. Does your employer use an incentive based safety program[lotteries, prizes, peer pressure not to report...] in your workplace to reduce reporting of accedents and injuries? Does your employer have any kind of Ergonomics program to reduce workplace injuries? Does your employer provide adequate translational facilitation for non-English speaking employees?

Any special need(s) in your workplace that WisCOSH may be able to help with.

All information is kept confidental and used only in an aggrregate/statistical form:

All entries marked with a * are required to submit this form.

Please give us your name:

First name *:   Last name *:

Your Address :

Street : , APT # : ,

City *:, State : ZIP Code *:

Please give us any ! or ? or suggestions you may have.

Your place of work *:

What type of work do you do:(check all that apply)
Office/Clerical Truck Driving Taxi/Chauffeur
Manufacturing Foundry Assembly
Machine Shop Construction/Demolition Warehouse/Dock
Railway Retail Sales Self Employed

How many workers at your job site? *
Do you have an union at your workplace? *
(if yes, please tell us your union name and local # .
(if no, and you are interested in a contact from a union organizer )

(for union workers)

Does your union have a Safety & Health Representitive?
Yes. No. I Don't Know.
Contact Person Phone #

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