Please choose one person I can liaise with
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Please note down which industry sector(s) best describes your business
Number of premises: *
What size is your business? *
Please note down what goals and expectations you have
e.g non-specific lower back pain
Please note down any issues that have recently come up
eg ergonomic chairs, lighting
eg screen breaks, desk breaks, correct lifting techniques
Does your company offer private health care which also covers complimentary therapies?
Staff turnover:
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Date Today *
Date Today
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Workplace assessment form


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