ADOSH - VPP - Pre-Screening Form

Instructions

ADOSH requires all new VPP Star candidates to fill out a pre-screening form. The form is used to provide the ADOSH Compliance Assistance Team with information related to your workplace. It also provides valuable information related to your injury and illness rates which is the starting point to determine if you qualify for the exemplary program. Once filled out and submitted, someone from the Compliance Assistant Team will reach out to schedule a meeting to discuss your site and develop a plan for action.

E-sign Electronic Submission Form