QUESTIONNAIRE Age: Sex: Male Female Height (estimate) : Weight (estimate) : cms kgs

1. Do you eat at regular intervals throughout the day ? Yes No

2. Have you ever smoked on a regular basics ? Yes . Do you go !or regular e"ercise ? Yes No No

#. Do you su!!er !rom any o! the !ollo$ing medical conditions? a. Diabetics c. 'holesterol e. )hyroid b. High % & d. (sthma !. (llergy

*. Ho$ many glasses o! $ater you +re!er +er day? 2,* *, (bove -

.. Ho$ o!ten do you take sick leave ?

/egulary

0ometimes

Never

-. Ho$ o!ten you go !or routine blood check u+ ? Monthly 1nces in t$o months Yearly

2. (re you a regular user o! s+ectacles ? Yes No

3. 4! ans$er to the above 5uestion is yes6 are you !acing di!!iculties in using goggles +rovided by the com+any? Yes No

17. Have you ever !orgot to $ear goggles inside the +lant? Yes No

11. Ho$ o!ten you $ash eyes a!ter $ork ? /egulary 0ometimes Never

12. Have ever under$ent treatment !or ear related +roblems be!ore 8oining ? Yes No

1 . Ho$ o!ten you enter inside the +lant $ithout ear +lugs ? /egulary 0ometimes Never

1#. Have you ever e"+erienced an incident inside the +lant by $hich your health deteriorated ? Yes No

1*. Have you ever got chance to attent health related seminars or +resentation? Yes No

1.. Do you !eel the health measures taken by the com+any is +rom+t ? Yes No

We value your opinion, i you have any other !o""ent# or #ugge#tion# that $ill help to "a%e $or%pla!e healthier, plea#e li#t &elo$

)hank you !or your time.