Worker Health and Safety Survey
This survey is being circulated by United Faculty and Academic Staff (AFT local 223) and the Teaching Assistants' Association (AFT local 3220) to better understand the health and safety concerns of workers across the UW-Madison campus during the COVID-19 pandemic. Please respond by July 14.
Sign in to Google to save your progress. Learn more
What is your comfort level about bringing students back to campus this fall, restarting research, and other in-person activities? *
What are your top safety and health concerns about working on campus? *
What (if anything) would make you feel like it's safe to work on campus? *
Is protective equipment (PPE) being provided for your campus work?
Clear selection
When do you anticipate working on campus?
Clear selection
If you are not currently working on campus, are you facing pressure to return by a certain date? If so, please describe to the extent you're comfortable.
Do you need to provide documentation of health risk (if any), to be exempted from in-person campus work? If so, please describe to the extent you're comfortable.
On a regular workday, how many people do you typically come into contact with on campus?
On a regular workday, how many campus buildings are you typically in?
How do you typically get to campus?
Clear selection
Would you like a union member to contact you to talk about your concerns?
Clear selection
If yes, please share your name and contact info.
In which department/ school/ division do you work?
Which type of position do you hold?
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms