Fill out this form if you are requesting a Puataunofo workshop at your workplace.

What this form will ask

WorkSafe needs to collect the information on this form so that we can better understand your business and workforce needs to plan how to best deliver the Puataunofo Programme for you. The information you provide is essential to support us to support you, and if information isn’t provided on the form you won’t be able to submit the workshop request. Information submitted on the form may also be used for reporting and research on the delivery of the Puataunofo programme.

The information you submit will be kept as outlined in WorkSafe’s Privacy statement and policy

If you have any concerns about the data collected on this form, please contact us on puataunofocomehomesafely@worksafe.govt.nz

1. Contact information
2. Workshop information
If more than one, please specify all locations
What is the ethnic breakdown of your workforce?
What is the age range of the majority of your workforce?
Select all that apply
What is the audience for the workshop?
Select all that apply
Will you require separate workshops for the different audience groups?
From your observation of your overall workplace, how do you rate your health and safety culture?
What are the main health and safety issues that your workforce faces?
Select all that apply
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