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Canada’s Healthy Workplace Month (CHWM) Evaluation Form

Your ideas matter to us! Please take a few moments to reflect your CHWM experience for 2010. Your feedback will help the CHWM team evaluate the effectiveness of the 2010 campaign as well as provide us with an opportunity to improve for 2011.

Please indicate your agreement with the following statements:

* required field

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To show our appreciation for your feedback, in return for a completed survey from your workplace, we will send you a free Healthy Workplace Month Eco-Friendly Ballpoint. Please fill in the following fields to receive this gift. Completing this section will not affect the confidentiality of your responses.

CHAMPIONS OF EXCELLENCE BENEFACTOR ADVOCATE
SUPPORTER
INDUSTRY