092-20BY AttachmentK_LSH_RespondentScreeningForm

Work Organization Risks to Short-haul Truck Drivers’ Health & Safety

AttachmentK_LSH_RespondentScreeningForm_Sept18

OMB: 0920-1345

Document [docx]
Download: docx | pdf

Respondent Screening Form


1) Are you 18 years of age or older?

  • Yes

  • No


2) Are you currently a L/SH truck driver?

  • Yes

  • No


3) Are you employed Full-Time as a L/SH truck driver?

  • Yes

  • No


4) Please state the company in which you are employed Full-Time as a L/SH truck driver


Company name:______________________


5) For how long have you been employed Full-Time as a L/SH truck driver? (inclusion = at least 6 months)


Tenure as employed FT L/SH truck driver:______________________




File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorMari-Amanda Dyal
File Modified0000-00-00
File Created2021-08-16

© 2024 OMB.report | Privacy Policy