ST JOHN AMBULANCE QUEENSLAND
WORKPLACE ASSESSMENT ENQUIRY FORM
Client Details
Company / Organisation
Account ID (
if known)
Contact Name
Contact Phone
Mobile Number
Business Address
Contact Email
(for booking)
Number of Employees
Pre-Assessment Questions
Have you previously completed a Workplace First Aid Assessment?
Yes
No
Is your workplace high or low risk?
High
Low
Unsure
Do you have sufficient first aiders in your workplace?
Yes
No
Unsure
Do you have sufficient first aid kits in your workplace, including vehicles?
Yes
No
Unsure
Do all first aiders in your workplace have current first aid qualifications?
Yes
No
Unsure
Does your workplace have adequate and visible first aid signage?
Yes
No
Unsure
Does your workplace have a current set of first aid procedures?
Yes
No
Unsure
Does your workplace run regular first aid drills?
Yes
No
Unsure
Does your workplace have a Defibrillator (AED)?
Yes
No
Unsure
Contact Information