UniFirst | Uniform and Program Needs Assessment - Let us help.

	1)	Our primary objective for considering UniFirst is the following:
	check all that apply
		Soil protection for workers
		Increased safety for workers
		Business image or identity
		Cross-contamination protection of food-related production processes consistent with HACCP practices
		Protection of production process from contamination of Medical/Health Procedures, Pharmaceutical Purity, or Ultra-clean Manufacturing
		None of the above

	2)	Our workers face the following soil conditions:
	check all that apply

	Heavy (frequent grease/oil contact)
	Medium (limited grease/oil contact)
	Light (no grease/oil contact)

	3)	Our employees are regularly exposed to the following hazards on the job:
	check all that apply

	Flames
	Electric arcs
	Hot surfaces
	Vehicular traffic
	Low light situations
	None of the above

	4)	Our employees interact with CUSTOMERS:
	Yes No

	5)	10 or more of our employees require Purchased uniforms or special work clothing:
	Yes No Don't Know

	6)	10 or more of our employees require Rented uniforms or special work clothing:
	Yes No Don't Know

	7)	10 or more of our employees require Leased uniforms or special work clothing:
	Yes No Don't Know

	8)	Our company does NOT currently have a work clothing service contract:
	Yes No Don't Know

	9)	Our company has a current work clothing supplier, but wants to consider new options:
	Yes No Don't Know

	10)	Our company utilizes the following Facility Services:
	check all that apply

	Floor mats
	Dry and/or wet mops
	Soaps and hand care products with dispensers
	Hand towel and sanitary tissue products with dispensers
	Air fresheners
	None of the above

	11)	How did you become aware of UniFirst and/or the UniFirst website?
	check all that apply

	Website search
	Recommendation of friend or associate
	UniFirst trucks in my area
	Print advertising
	Radio or TV advertising
	Billboard advertising
	Articles in newspaper, magazine, or other
	Other

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