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About Work Well, Live Well
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Contact Details
Name
Title
Title
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Miss
Ms
Mr
Mrs
Dr
Other…
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First
Last
Telephone
Email
Business/Organisation Details
Business/organisation name
Address
Address
Address 2
City/Town
County
Postcode
Council Area
- None -
Antrim and Newtownabbey
Ards and North Down
Armagh, Banbridge and Craigavon
Belfast
Causeway Coast and Glens
Derry and Strabane
Fermanagh and Omagh
Lisburn and Castlereagh
Mid and East Antrim
Mid-Ulster
Newry, Mourne and Down
Email
Telephone
Fax
No. Of Employees
About your organisation
What is your job within the business or organisation?
CEx/ Director
Senior Management
HR Manager
Workplace Health and Well-being Lead
Workplace Champion
Other…
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What type of business are you?
Private sector
Public sector
C&V Sector
What are your average sickness absence levels per employee each year?
Less than 4 days
4 - 10 days
More than 10 days
What are the most common reasons for sickness absence?
Back and neck pain
Minor illnesses- coughs and colds
Stress
Other…
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How well would you rate the communication or engagement between management and employees?
(1 poor and 5 excellent)
Questions
1
2
3
4
5
How well would you rate the communication or engagement between management and employees?
1
2
3
4
5
How does your business communicate with employees?
Wage slips
Team meetings
Supervision 121
Letter
Staff Newsletter
Emails
Text
Posters in the kitchen/staff room
Intranet
Other…
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What if any workplace policies do you have in place?
Health & Safety
Attendance Management
Flexible working
Carer's leave/support
Return to work after long term absence
Bullying and Harassment
Please list any other policies relating to Health and well-being you may have?
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What is the main type of work your employees do?
Sedentary
Manual and Sedentary
Manual
What patterns do your employees work?
Tick all that apply
Regular hours e.g. 9-5pm
Day shift patterns
Day and night shift patterns
Overtime on a weekly basis
Overtime less frequently
Do you offer line management training, if yes what do you provide?
Stress management
Equality and Diversity
Bullying and Harassment
Other…
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Does your company currently provide any health and well-being support?
Tick all that apply
Healthy food choices in the canteen
Workplace Gym and shower facilities
Counselling
Cycle to work scheme
Lunchtime yoga
Mental health awareness training
Health Promotion events
Cancer awareness
Health screening checks
Health Fair
Other…
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Does your company offer opportunities to work with the community?
Volunteering opportunities
Away days involving community schemes
Sharing skills schemes
Fundraising events
Why is your business getting involved in health and well-being?
Concern about sickness absence levels
Retention of staff is a concern
Makes good business sense
Improve company image
Aging workforce concerns
Other…
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