PRE-CONSULTATION QUESTIONNAIRE

Please answer the following questions in confidence by typing in and submitting your responses. Your consultation date and times requested will then be confirmed.

Name Email

PART 1 – Your Business or Organisation

1.1). Business/organisation name:
1.2). Location/s:
1.3). Primary industry – (e.g. financial services, manufacturing, retail, etc):
1.4). Your position in the business/organisation:
1.5). Number of employees in the business/organisation:

PART 2 – Sickness Absence and Ill-health at Work

2.1). Current sickness absence indicators:–

  • Frequent short term absence   -  Concerned?
  • Long term (over 15 working days)  -  Concerned?
2.2). Stress/mental health trends (e.g. depression/anxiety) -  Concerned?
2.3). Employee performance issues  -  Concerned?
2.4). Other health at work matters/questions you would like to discuss:

Thanks for your time – we will be in touch shortly.



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