Slip Trip and Fall Monthly Questionnaire This is the monthly questionnaire for the Slip Trip and Fall nspection Company Name(Required)Safety Coordinator(Required) First Last Safety Coordinator Email(Required) Phone(Required)Name of Individual Conducting Inspection(Required) First Last Date of Inspection(Required) MM slash DD slash YYYY Where there any changes made?During last month were there any injuries due to a slip or trip?(Required) Yes No InjuriesLocationDescriptionHow corrected Add RemoveDuring last month were there any slipping hazards observed?(Required) Yes No Slipping hazardsLocationDescriptionHow corrected Add RemoveDuring last month were there any tripping hazards observed?(Required) Yes No Tripping hazardsLocationDescriptionHow corrected Add RemoveThis field is hidden when viewing the formMonthly Report(Required)
