1. Do you have a job? Yes No

2. Is your job Full-time Casual Part-time ?

3. In which industry do you work?

4. How many hours a week do you work? 0 - 9 10 - 19 20 - 29 30 - 39 40+

5. Are your hours approximately the same each week? Yes No

6. What is your hourly rate?

7. Would you like to work more hours? Yes No

8. Would you like to work fewer hours? Yes No

9. Do you ever feel pressured to work when not rostered on? Yes No

10. Do you feel comfortable saying "no" to extra shifts? Yes No

Why / Why not?

11. What do you think the consequences would be if you refuse extra work?

12. How often do you have breaks?

13. Is it hard to have a toilet break? Yes No

14. Have you ever been injured at work? Yes No

If so, how did it happen?

15. What action was taken?

16 Did you need time off as a result? Yes No

17.Do you feel comfortable reporting injuries? Yes No

Why / Why not?

18. Are injuries common in your workplace?  Yes No

19. Is medical assistance always available? Yes No