Instep Limited

ADFWP Checklist

A. Details(email address is required)

Name
Role
Organisation

Phone
Fax
Email

A. General

1. Is alcohol and/or drug abuse by employees of concern to your organisation Yes No

2. If Yes, are you interested in a proposal from Instep? Yes No

3. Number of worksites?

4. Unionised workplace? Partial Yes No

5. ACC Partnership Programme member? Yes No

6. If No, are you interested in ACC's Work Safety Management Practices Programme that may attract up to a 20% rebate on your ACC premium? Yes No

B. Policy and Procedures

7. Need one developed? Yes No

8. Need existing policy and procedures reviewed and updated? Yes No

C. Testing

9. Need a workplace drug testing consultant to advise? Yes No

10. If testing already, what additional testing do you wish to consider?

Pre-emp
Post-accident/incident
Reasonable Cause
Random
Follow-up

D. Education

11. Need an educator to speak to:

Senior management team
Managers
Supervisors and employees

12. Interested in partners, family memners or local community also attending? Yes No

E. Training

13. Interested in workshops? Full Day? Half Day?

14. Number of people required for training?

F. Case Management

15. Need a consultant to advise on specialist case management? Yes No

G. Rehabilitation

16. Interested in further details on rehabilitation, costs and how my organisation can access public or private sector treatment for our employees? Yes No

The information gathered in this checklist will be treated in strict confidence and not disclosed to any third party without express permission of the client organisation.

Instep Wellington
PO Box 19240
Wellington 6149
Ph.: 04 382 8071
admin@insteplimited.com

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