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Mining Safety Culture & Incident Reporting Survey

Evaluate mine site safety culture and incident/near-miss reporting with a ready-to-use template. Engage crews, spot risk gaps, boost compliance, cut accidents.

What's Included

AI-Powered Questions

Intelligent follow-up questions based on responses

Automated Analysis

Real-time sentiment and insight detection

Smart Distribution

Target the right audience automatically

Detailed Reports

Comprehensive insights and recommendations

Sample Survey Items

Q1
matrix
Please indicate how much you agree with each statement (past 30 days).
Q2
rating
Over the past 30 days, safety was prioritized over production on my crew.
Q3
multiple choice
How do you usually report hazards, near misses, or incidents on this site? Select all that apply.
  • Tell supervisor in person
  • Paper or card
  • Radio/phone call
  • Mobile app
  • Computer kiosk/terminal
  • Safety hotline
  • Toolbox talk/team meeting
Q4
dropdown
When a hazard or near miss occurs, how often do you personally report it? (past 30 days)
Q5
numeric
How many near-miss events did you personally observe in the past 30 days? Enter 0 if none.
Q6
numeric
On average, how many minutes does it take you to complete a typical safety report?
Q7
multiple choice
Which of the following have you reported in the past 90 days? Select all that apply.
  • Near miss
  • Minor injury (first aid)
  • Recordable injury
  • Unsafe condition/housekeeping
  • Equipment damage/failure
  • Environmental spill/release
  • Vehicle incident
Q8
multiple choice
What makes reporting harder on your site? Select all that apply.
  • Unclear what should be reported
  • Takes too much time to complete
  • Fear of blame or negative consequences
  • Little or no feedback after reporting
  • Reporting system is difficult to use
  • Belief that minor issues don’t matter
  • Lack of supervisor support
  • Language or communication barriers
Q9
ranking
Please rank what most motivates you to report, from most to least motivating.
Q10
opinion scale
In the past 90 days, I could report issues without fear of blame or punishment.
Q11
opinion scale
I clearly know what should be reported and how to do it (past 30 days).
Q12
opinion scale
Attention check: To confirm you are paying attention, please select "Agree" for this item.
Q13
dropdown
What is your primary job role on this site?
Q14
dropdown
What is your employment status?
Q15
dropdown
What shift do you typically work?
Q16
dropdown
How long have you worked in mining?
Q17
dropdown
How long have you worked at this site?
Q18
dropdown
What is your primary work environment?
Q19
dropdown
Which region do you primarily work in?
Q20
long text
What would make reporting easier or faster at this site? Be specific if possible.
Max 600 chars
Q21
chat message
Welcome! This short survey takes about 5–7 minutes. Please answer based on your recent experience (past 30–90 days). Your responses are confidential and used to improve safety.
Q22
ai interview
AI Interview: 2 Follow-up Questions on Site Safety Reporting
AI Interview
Q23
chat message
Thank you for completing the survey. Your input helps strengthen safety and reporting on site.

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Mining Safety Culture & Incident Reporting Survey - Survey Template | QuestionPunk