Pandemic 101

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Corporate Readiness Questionnaire

Contact Information

Please fill out all the following fields completely.

First Name:
Last Name:
Organization:
Country:
Phone Number:
Email Address:

Your Corporation's Needs

Please fill out all of the following fields completely.

		How many people do you employ?
YES	NO	Is proof of your organization's pandemic preparedness important to you or your customers?
YES	NO	Does your organization have a pandemic plan or are you currently working on one?
YES	NO	Do you have HR/legal policy regarding return to work and refusing entry and employee refusal to work?
YES	NO	Do you have medical directives governing infectious disease control guidelines within your organization?
YES	NO	Do you have a medical director to oversee policy and implementation during an infectious disease outbreak?
		How many employees work inside and do not have regular public contact?
		How many employees work inside and have regular public contact?
		How many employees work off site directly with customers?
		How many employees work in the health care industry?
		How many employees will be directed to work from home?
		How many access points will your workplace have during a declared pandemic?
YES	NO	Has your organization developed a pandemic training program for employees?
YES	NO	Does your organization have access to an exercise to test your plan?
YES	NO	Do you have an inventory or access to antiviral medications ie, Tamiflu for your employees?