| 1) Have you been involved in a workplace incident previously? In this workplace or previously? |
| 2) Describe the incident (what were the consequences) |
| 3) Describe the incident location |
| 4) What was your role |
| 5) What went wrong in your opinion |
| 6) Do you think the work conditions contributed to the incident? How? |
| 7) Did you suffer from work stress prior to the incident (overloaded, busy schedule, no breaks, and long working hours), which contributed to the incident? |
| 8) Did you suffer from home stress prior to the incident (not enough sleep, family/friends problems), which contributed to the incident? |
| 9) What was your health condition prior to the incident |
| 10) Did you take medication prior to the incident |
| 11) What do you think the employer should’ve done to prevent this incident |
| 12) Refer to the above table; which of the rating questions the employer needs to improve |