Safe+Sound Week Webpage Mock-up for PRA Package upated 4.5

Safe+Sound Week Webpage Mock-up for PRA Package upated 4.5.pdf

Department of Labor Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Safe+Sound Week Webpage Mock-up for PRA Package upated 4.5

OMB: 1225-0088

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Safe + Sound Week ~ June 12-18, 2017
Show Your Commitment to Safety
Safe + Sound Week
Home
Step 1: Select your
activities
Step 2: Plan &
promote your events
Step 3: Recognize
your participation
Co-sponsors and
partners
Contact us

Join us for the inaugural Safe + Sound Week!
What Is Safe + Sound Week?
A nationwide event to raise awareness and understanding of the value of
proactive safety and health programs in workplaces.
Why Participate?
Safe workplaces are sound businesses. Successful safety and health
programs can proactively identify and manage workplace hazards before
they cause injury or illness, improving sustainability and the bottom line.
Participating in Safe + Sound Week can help get your program started or
energize an existing one.
Who Is Encouraged to Participate?
Organizations of any size or in any industry looking for an opportunity to
show their commitment to safety to workers, customers, the public, or
supply chain partners should participate.
How to Participate
Participating in Safe + Sound Week is easy. To get started, select the
activities you would like to do at your workplace. Some organizations might
want to host a public event. Examples of potential activities and tools to
help you plan and promote your events are available. After you’ve
completed your events, you can download a certificate and web badge to
recognize your organization and your workers.

Safe + Sound Week across the country
Are you participating?

Twitter

Safe + Sound Week
Home
Step 1: Select your
activities
Step 2: Plan &
promote your events
Step 3: Recognize
your participation

Congratulations and thank you for participating in the inaugural Safe + Sound Week!
To download a certificate of recognition and web badge for your organization’s participation, please fill
out the required information below. We also hope that you will help us by answering a few optional
questions about your participation and giving us feedback on our efforts. Please note that you are not
required to request a certificate of recognition and web badge and that if you choose to do so, OSHA
will not use the information or feedback you provide for any purpose other than evaluating Safe +
Sound Week and planning future outreach efforts. Also note that the certificate and web badge do not
represent an assessment of compliance with OSHA standards at your worksite(s).
Items marked * are mandatory to download the participation completion packet.

Co-sponsors and
partners
Contact us

Participant Satisfaction Survey
1) Name of Business or Organization*:
_____[FILL IN BLANK]_______________________________________________________
2) City/State and Zip code*:
_____[FILL IN BLANK and DROP DOWN]________________________________________
3) Industry*:
_____ [DROP DOWN]_______________________________________________________
4) Number of Workers Impacted by Safe + Sound Week Activities*:
______[FILL IN THE BLANK]__________________________________________________
5) Which safety and health program core elements did you include in your Safe + Sound
Week activities? (Check all that apply) [CHECK BOX]
 Management Leadership
 Worker Participation
 Finding and Fixing Hazards
6) Participating in Safe + Sound Week had a positive impact on safety & health in my
organization.
Strongly Disagree
[CHECK BOX]

1

2

3

4

5

NA

Strongly Agree

Comments: __[FILL IN THE BLANK]_____________________________________________
7) The resources provided on the Safe + Sound Week website were helpful in planning
my events.
Strongly Disagree
[CHECK BOX]

1

2

3

4

5

NA

Strongly Agree

Comments: __[FILL IN THE BLANK]_____________________________________________
8) Tell us about your Safe + Sound Week experience. What did you do?
____[FILL IN THE BLANK] ____________________________________________________
9) What would improve your participation experience in the future?
____[FILL IN THE BLANK] ____________________________________________________
10) Would you like to share a quote about any success, impacts, or outcomes related to
your Safe + Sound Week activities?
____[FILL IN THE BLANK] ____________________________________________________
11) Are you interested in sharing more about your experience? [CHECK BOX]
 Yes
 No
If yes, please provide contact information:
Contact Name: ____________________________________________________________
Contact Email: _____________________ Contact Phone Number: _________________


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File Modified2017-04-07
File Created2017-04-05

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