Employer Invitation Email

Whistleblower Alternative Dispute Resolution Program Survey Information Email Employer
(The Regional ADR Coordinator will send the following email to mediation participants
(employers) approximately one week after the mediation)

To:

Mediation Participant (Employer)

From:

Regional ADR Coordinator

Subject:

Whistleblower Alternative Dispute Resolution Program Customer Feedback
Questionnaire

Thank you for participating in OSHA’s Whistleblower Alternative Dispute Resolution (ADR)
Program. Your input and satisfaction are important to OSHA and to the success of OSHA’s
ADR Program. OSHA would appreciate your participation in a voluntary 10-Question Customer
Feedback Questionnaire, available at the link below. Please answer each question honestly and
to the best of your ability. Thank you once again for your cooperation and your participation in
OSHA’s Whistleblower ADR Program. If you should have any questions regarding this
questionnaire, please call the National ADR Coordinator at (202) 693-2199.
Privacy
Please note that this questionnaire is being administered by SurveyMonkey.com and resides on a
server outside of OSHA’s domain. OSHA cannot guarantee the protection of questionnaire
responses and advises against the inclusion of sensitive, personally-identifiable information—
such as your full name, phone number, e-mail address, etc. in any response. Completion of this
questionnaire is completely voluntary and information collected will be kept private to the extent
permitted by law and used for program evaluation purposes only.
Survey Access:

http://www.surveymonkey.com/s/27ZY5VD

Paperwork Reduction Act 1995
Public reporting burden for this voluntary collection of information is estimated to take 30 minutes per response including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An Agency may not conduct
or sponsor, and persons are not required to respond to the collection of information unless it displays a valid OMB Control Number. Send comment regarding this
burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to the Office of the Whistleblower Protection
Program, OSHA, Department of Labor, Room N-4624, 200 Constitution Ave., NW, Washington, DC; 20210.
OMB Approval # 1225-0088; Expires: 06-30-2014