indicates required field

2025 Small Business Health and Safety Leadership Awards online submission form

Please complete the submission form and tell us about the great work you’ve done over the past year to improve workplace health and safety.

Candidates that move to the second round of judging will need to:

Provide documentation to support your submission
Be available for and participate in an interview
Involve your employees in the process

You must meet all Small Business Health and Safety Leadership Awards eligibility requirements to be considered for an award.

Important note: You can complete the online submission form in multiple sessions and save your drafts. Please do not delete your browser cookies while your draft form is saved. You only have 48 hours to submit the form once you begin completing it. The information you input in the form will be deleted after 48 hours if you don’t submit it within that timeframe.

Submissions are due May 14, 2025.

Email [email protected] if you need a different format or accommodation.

Business name:

WSIB account number:

Business contact first name, last name:

Title:

Business website:

Telephone number of key contact:

Email address of key contact:

Address:

City/town:

Postal code:

What does your business do?

How long have you been in business?

In which industry sectors does your business operate?

How did you hear about the Small Business Health and Safety Leadership Awards? Please choose one:

WSIB website

WSIB social media (LinkedIn/X)

WSIB email

WSIB employee

Health and Safety Excellence program provider

Health and safety partner (Ministry of Labour, Immigration, Training and Skills Development, etc.)

LinkedIn advertisement

Online magazine/news article

Other

WSIB employee

Health and Safety Excellence program provider

Health and safety partner (Ministry of Labour, Immigration, Training and Skills Development, etc.)

Other

Tell us about a health and safety program or initiative you implemented in your workplace within the last year.

What problem were you trying to solve?
How did you solve the problem, and what steps did you take to incorporate that solution into your business?
What issues did you encounter? How did you resolve them?
How successful were you? How did you know?
Who on your team was involved in the work, and what were their roles?

How did you communicate the problem you were solving and the solution you implemented to the rest of your business?

Are there any other ways your company usually communicates health and safety updates that you didn’t use for this project?

What role did your leadership team play in solving this problem? (Leadership can refer to a business owner, president, supervisor, senior manager or anyone else who is responsible for employees’ well-being and work).

How does your leadership team take responsibility for health and safety in your workplace?
How do you know the leadership team is working to ensure you have a safe and healthy workplace? Please give us some examples.

Tell us how you asked for and received feedback from employees about the health and safety problem you solved.

Did you need feedback from employees?
How do you usually get feedback from employees about workplace health and safety?
What do you routinely do to find out how employees feel about their health and safety at work? What do you do with the feedback you receive?

I certify that the information I have provided is true and accurate.

Electronic candidate signature:

Use your mouse or touch screen to sign electronically

Date of submission (dd/mm/yyyy):

Note: If your entry is chosen for our shortlist, you’ll be asked to send us supporting information for the answers you provided in your submission form. The types of files you can send us include photos, documents, videos, signage, certifications, etc.

If you need help with the submission process, please email us at [email protected] — we’re happy to help.