Discovery Call Request Step 1 of 3 33% Consent(Required)This information will only be used to identify your H&S requirements and will not be used for any other purpose. I agree to the privacy policy.Company DetailsTo enable us to assist you in the best way we ask that you complete this form giving as much detail as you can.Company Name(Required) Address(Required) Street Address Address Line 2 City County Post Code Contact Name(Required) First Last Contact Phone(Required)Contact Email(Required) Short Description of Business Company FinancialsHave any of the company Directors ever been declared bankrupt and/or filed for insolvency?(Required) Yes No Has the company ever had any County Court Judgement (CCJs) passed against them?(Required) Yes No Does the company currently have any outstanding debts?(Required) Yes No Risk Section 1Industry Type(Required)Please highlight the industry type that best represents your organisation Office/Administration Retail Light Industry/Warehousing Manufacturing Construction/Agriculture Other Risk Section 2Work Risk Level(Required)Please highlight the level of risk that best represents your organisation Low Low-Medium Medium Medium-High High Other Risk Section 3H&S History(Required)Please highlight the H&S history which best represents your organisation No Previous H&S Issues Start-up Business Minor Accidents Major Accidents/RIDDOR Fatalities/Prosecutions/FFI Risk Section 4Number of Employees(Required)Please highlight the number of employees which best represents your organisation 0 - 5 6 - 15 16 - 30 31 - 49 50 + CommentsThis field is for validation purposes and should be left unchanged.
