Workplace Health and Safety Audit Form

1. General Information

This audit form is designed to help organizations identify potential hazards, assess risks, and ensure a safe working environment for all employees. Please complete all sections thoroughly.

 

Organization Name

Department/Unit Being Audited

Audit Location/Facility

Audit Date

Auditor Name(s)

Department/Area Manager

Number of Employees in This Area

Primary Activities/Operations in This Area

2. Work Environment & Physical Conditions

Is the workplace clean and free of excessive clutter?

 

Please describe any areas where cleanliness could be improved:

Are walkways and exit routes clearly marked and unobstructed?

 

Describe the obstructions or marking issues:

Is adequate lighting provided throughout the work area?

 

Specify areas with poor lighting:

Is the ventilation sufficient to maintain air quality?

 

Describe air quality concerns:

Are noise levels within acceptable limits for the type of work?

 

Explain noise issues and affected areas:

Are temperature and humidity levels comfortable for work activities?

 

Describe temperature/humidity issues:

Which of the following physical hazards are present? (Select all that apply)

Overall, how would you rate the physical work environment?

3. Emergency Preparedness

Are emergency exits clearly marked and easily accessible?

 

Identify problematic exits:

Are emergency evacuation procedures displayed and communicated to all employees?

 

Describe communication gaps:

Are first-aid kits available and adequately stocked?

 

Specify location and supply issues:

Are employees trained in basic first-aid procedures?

 

Explain training gaps:

Is there a clear procedure for reporting emergencies?

 

Describe reporting procedure issues:

Are emergency contact numbers posted in visible locations?

 

Where are numbers missing?

Are fire extinguishers available and regularly inspected?

 

Specify extinguisher issues:

Have emergency drills been conducted in the past 12 months?

 

When was the last drill and what type?

How confident are employees in emergency procedures?

4. Equipment & Machinery Safety

Is all equipment regularly inspected and maintained?

 

List equipment with overdue maintenance:

Are machine guards and safety devices in place and functional?

 

Describe missing or faulty guards:

Are operating instructions clearly displayed on or near machinery?

 

Identify machinery without instructions:

Are employees trained and authorized to operate specific machinery?

 

Describe training/authorization gaps:

Are lock-out/tag-out procedures implemented for maintenance work?

 

Explain lock-out/tag-out issues:

Are personal protective equipment (PPE) requirements clearly identified?

 

Where are PPE requirements unclear?

Which types of PPE are required in this area? (Select all that apply)

Is PPE readily available to all employees?

 

Describe PPE availability issues:

How would you rate the overall condition of equipment and machinery?

5. Chemical & Hazardous Substance Management

Are Safety Data Sheets (SDS) available for all chemicals used?

 

List chemicals without SDS:

Are all chemical containers properly labeled?

 

Identify improperly labeled containers:

Are chemicals stored in appropriate, segregated areas?

 

Describe storage issues:

Are employees trained in chemical handling procedures?

 

Explain training deficiencies:

Is there adequate ventilation in areas where chemicals are used?

 

Specify ventilation problems:

Are spill containment materials readily available?

 

Where are spill materials needed?

Are waste chemicals disposed of properly?

 

Describe disposal issues:

Which types of hazardous substances are present? (Select all that apply)

How would you rate chemical safety management in this area?

6. Ergonomic & Human Factors

Are workstations adjustable to accommodate different body sizes?

 

Describe workstation limitations:

Do employees receive training on proper lifting techniques?

 

Explain training gaps:

Are there opportunities for employees to vary their posture during work?

 

Describe posture limitations:

Are rest breaks provided during repetitive or intensive tasks?

 

Explain break schedule issues:

Are tools and controls within easy reach of employees?

 

Identify reach-related issues:

Is there excessive vibration from tools or equipment?

 

Specify sources of vibration:

Have employees reported musculoskeletal discomfort?

 

Describe reported issues:

Which ergonomic issues have been observed? (Select all that apply)

How would you rate the overall ergonomic conditions?

7. Training & Competency

Do all employees receive safety orientation when hired?

 

Describe orientation gaps:

Are employees trained on specific hazards in their work area?

 

Identify untrained hazards:

Is safety training provided in languages employees understand?

 

Specify language barriers:

Are training records maintained and up-to-date?

 

Describe record-keeping issues:

Do employees receive refresher training periodically?

 

Explain refresher training gaps:

Are contractors and visitors briefed on safety requirements?

 

Describe contractor/visitor briefing issues:

Is there a system to verify employee understanding after training?

 

Explain verification methods:

Which training topics are covered? (Select all that apply)

How would you rate the effectiveness of safety training?

8. Incident Management & Reporting

Are all incidents, including near-misses, reported?

 

Describe under-reporting issues:

Is there a clear procedure for reporting incidents?

 

Explain reporting procedure issues:

Are incidents investigated to identify root causes?

 

Describe investigation gaps:

Are corrective actions implemented after incidents?

 

Explain corrective action issues:

Is incident data analyzed for trends?

 

Describe trend analysis gaps:

Are employees encouraged to report incidents without fear of blame?

 

Describe blame culture issues:

Are incident records maintained confidentially?

 

Explain confidentiality concerns:

How many incidents (including near-misses) occurred in the past 12 months?

How would you rate the incident management system?

9. Risk Assessment & Control

Have risk assessments been conducted for all work activities?

 

List activities without risk assessments:

Are risk assessments reviewed and updated regularly?

 

Describe review frequency issues:

Are employees involved in the risk assessment process?

 

Explain employee involvement gaps:

Are control measures implemented according to the hierarchy of controls?

 

Describe control implementation issues:

Are control measures monitored for effectiveness?

 

Explain monitoring gaps:

Is there a process for identifying new hazards?

 

Describe hazard identification process issues:

Which control measures are commonly used? (Select all that apply)

How would you rate the effectiveness of risk controls?

10. Health & Wellness Programs

Are wellness programs available to employees?

 

Describe available wellness programs:

Are health screenings or check-ups provided?

 

Describe health screening programs:

Is there support for employees with work-related health issues?

 

Describe support gaps:

Are stress management resources available?

 

Describe stress management resources:

Is there a return-to-work program for injured employees?

 

Describe return-to-work program issues:

Are employees encouraged to take regular breaks?

 

Explain break encouragement issues:

Which health and wellness initiatives are in place? (Select all that apply)

How would you rate the organization's health and wellness efforts?

11. Communication & Consultation

Is safety information communicated in multiple formats?

 

Describe communication format limitations:

Are safety meetings held regularly?

 

Explain meeting frequency issues:

Are employees consulted on safety matters?

 

Describe consultation gaps:

Is safety performance feedback provided to employees?

 

Explain feedback system issues:

Are safety suggestions from employees encouraged and acted upon?

 

Describe suggestion system issues:

Is safety information available in appropriate languages?

 

Identify language barriers:

Which communication methods are used? (Select all that apply)

How would you rate safety communication effectiveness?

12. Overall Assessment & Recommendations

Please rate the following aspects of workplace health and safety:

Very Poor

Poor

Fair

Good

Excellent

Physical work environment

Emergency preparedness

Equipment safety

Chemical management

Ergonomic conditions

Training effectiveness

Incident management

Risk assessment process

What are the top three safety strengths in this area?

What are the top three safety concerns or hazards identified?

What immediate actions are recommended to address critical safety issues?

What long-term improvements would enhance safety in this area?

Target date for implementing critical safety improvements

Overall, how would you rate the safety culture in this area?

How confident are you that this workplace is safe for all employees?

Additional comments, observations, or suggestions for improvement

Auditor Signature

 

Analysis for Workplace Health and Safety Audit Form

Important Note: This analysis provides strategic insights to help you get the most from your form's submission data for powerful follow-up actions and better outcomes. Please remove this content before publishing the form to the public.

Overall Form Strengths

The Workplace Health and Safety Audit Form is a comprehensive, globally-relevant instrument that systematically evaluates eight critical domains of occupational safety. Its strength lies in the logical flow from general information to specific risk areas, the consistent use of conditional follow-ups that only solicit details when a deficiency is flagged, and the balanced mix of quantitative ratings and qualitative narrative fields. By mandating only ten key fields—primarily identification, incident count, and final recommendations—the form keeps administrative burden low while ensuring that the data needed for trend analysis and corrective-action tracking is captured.

 

Another design advantage is the embedded guidance: placeholder examples (e.g., "Manufacturing, Office Work, Laboratory") reduce ambiguity, while the progressive matrix rating in the final section allows auditors to quickly benchmark multiple sub-systems on the same 5-point scale. From a data-quality perspective, the heavy use of closed-ended questions (yes/no, multiple-choice, rating scales) produces standardized, analyzable outputs, whereas the optional narrative follow-ups preserve the richness needed for root-cause analysis. Privacy is respected because no personally identifiable employee data are requested; only aggregate counts and role-based identifiers (auditor names, manager names) are collected.

Question-Level Insights

Organization Name

This opening field anchors every subsequent comparison. Because the form is designed to be used across departments, facilities, and even countries, capturing the exact legal entity name ensures that corporate safety dashboards can aggregate or disaggregate findings by subsidiary, region, or certification scope. The single-line open-ended format invites correct spelling while avoiding the constraints of a drop-down that might omit mergers or recent re-branding.

 

From a user-experience standpoint, placing this question first leverages the primacy effect: auditors expect to state whom they are auditing before drilling into details. The mandatory nature eliminates the risk of orphaned records and allows downstream analytics to link incident rates to specific organizational units for benchmarking against industry averages.

 

Data-collection implications are minimal but positive: the field is low-effort, low-sensitivity, yet high-value for longitudinal tracking. No personal data are revealed, so GDPR or HIPAA concerns do not apply, making completion friction almost negligible.

 

Department/Unit Being Audited

Granularity at the department level is essential because safety performance can vary dramatically between a warehouse and an adjacent office pod. Capturing this field as mandatory text (rather than a pre-defined list) accommodates idiosyncratic organizational structures such as "Night-Shift Finishing Line A" or "Remote Sales Hub – APAC."

 

The field’s open-ended nature future-proofs the form against reorganizations or mergers; no maintenance of pick-lists is required. However, auditors should be trained to use consistent naming conventions to prevent data-cleaning issues later (e.g., "HR" vs. "Human Resources"). A small auto-suggest enhancement could be added in a digital deployment without altering the form’s intent.

 

From an analytic lens, pairing this field with incident counts enables heat-map visualizations that quickly spotlight chronic problem areas, guiding resource allocation for corporate safety teams.

 

Audit Location/Facility

Multi-site enterprises need to separate findings by physical address to satisfy both internal governance and external regulators (OSHA, HSE, ISO 45001 auditors). Making this field mandatory guarantees that corrective-action trackers can pinpoint the exact building, floor, or campus where a hazard exists, preventing costly follow-up audits caused by vague references.

 

The text format again provides maximum flexibility for international entries that may include non-Latin characters or lengthy facility codes. Auditors can append GPS coordinates or QR-coded asset tags if desired, future-proofing the dataset for IoT integration.

 

Because location often determines which legal jurisdiction applies, this single field implicitly drives the severity classification of findings and the timeline for remediation, thereby influencing compliance risk scores.

 

Audit Date

Temporal context converts isolated observations into trend data. By enforcing the audit date, the form enables month-over-month or seasonal analysis—crucial for cyclical businesses such as retail distribution peaks or agricultural processing.

 

A date-picker control (in digital versions) reduces format inconsistencies and prevents future-dated entries that would corrupt KPI dashboards. The mandatory requirement also discourages auditors from leaving the field blank when conducting multiple areas in one day, ensuring traceability.

 

Combined with incident counts, the date field supports calculation of rolling injury rates (e.g., TRIR) that many corporations must report to insurers and shareholders, thereby elevating the business value of what might otherwise be a routine administrative entry.

 

Auditor Name(s)

Accountability and expertise level are established by recording who performed the audit. This transparency is vital when findings are later challenged in union grievances, insurance claims, or regulatory appeals. The single-line format accommodates pairs or teams ("Maria Gomez & Certified Safety Partner"), balancing brevity with attribution.

 

Mandatory disclosure also deters "ghost audits" and encourages peer review: auditors know their professional reputation is linked to the quality of submitted reports. Over time, organizations can correlate auditor identity with corrective-action closure rates, identifying high-performing individuals or those who may need calibration training.

 

Privacy is managed because only names are collected; no employee ID numbers or contact details are required, keeping the field lightweight from a data-protection standpoint.

 

Department/Area Manager

Linking findings to the local line manager embeds safety accountability within operational leadership rather than relegating it to a corporate safety silo. Making this field mandatory ensures that follow-up emails and action plans are routed to the person with the greatest ability to allocate resources and implement change.

 

The text entry avoids pick-list maintenance issues when managers change roles, but organizations should still normalize entries during data ingestion to facilitate dashboard filtering. Over time, analytics can reveal whether certain managers consistently close actions faster, supporting leadership development and performance reviews.

 

From a cultural perspective, visible attribution fosters a sense of ownership; managers are more likely to accompany auditors during walk-throughs when they know their name will appear on the final report.

 

Number of Employees in This Area

This numeric field converts raw incident counts into rates, enabling fair comparison across departments of differing headcounts. Without it, a large manufacturing line would always appear riskier than a small quality lab, skewing prioritization algorithms.

 

Mandatory capture ensures that downstream safety indices (e.g., LTIR, DART) can be auto-calculated, saving analysts from manual lookups in HR systems. The numeric constraint prevents text entries that would break analytics pipelines.

 

Because the number reflects exposure hours, it also underpins OSHA 300-A log preparation, making this simple integer a lynchpin for both internal dashboards and external compliance submissions.

 

Primary Activities/Operations in This Area

Contextualizing the environment via activities (e.g., "Injection Molding" or "Cold-Storage Warehousing") allows risk-profiling algorithms to benchmark against industry codes such as NAICS or ISIC. The placeholder examples guide auditors toward standardized terminology, improving inter-rater reliability.

 

Mandatory completion prevents generic entries like "Operations" that would dilute benchmarking value. Over time, activity descriptors can be mapped to predefined hazard libraries, enabling predictive analytics that flag missing controls before incidents occur.

 

User friction is minimal because auditors need only summarize what they observe; no deep technical knowledge is required, yet the data harvested is rich enough for actuarial teams to refine insurance premiums.

 

How many incidents (including near-misses) occurred in the past 12 months?

This numeric, mandatory field quantifies recent safety performance and directly feeds organizational key risk indicators. Capturing near-misses is especially powerful because it surfaces latent conditions that could escalate into serious injuries under slightly different circumstances.

 

Near-miss data are often under-reported due to cultural barriers; however, by embedding the request in a formal audit rather than an incident form, the question signals organizational sincerity about learning, not blaming. Auditors can triangulate the number with documentation reviews, increasing data accuracy.

 

Because the 12-month window aligns with insurance renewal cycles, the metric becomes a defacto scorecard that influences premium negotiations, making this seemingly simple integer a high-stakes data point.

 

What are the top three safety strengths in this area?

Requiring narrative input about strengths prevents audits from becoming exclusively deficit-focused. Documenting what works well provides a repository of best practices that can be replicated across sites, accelerating enterprise-wide improvement.

 

Mandatory completion also balances the psychological contract with audited managers: they perceive the process as fair and constructive rather than a punitive exercise, increasing buy-in for corrective actions. Over time, thematic analysis of strengths can reveal cultural enablers such as strong supervisory engagement or effective use of digital tools.

 

From a data-architecture perspective, the open text is semantically rich; natural-language processing can later auto-tag themes (e.g., "weekly safety huddles" or "predictive maintenance"), feeding knowledge-management systems without extra auditor effort.

 

What are the top three safety concerns or hazards identified?

Mandatory disclosure of hazards ensures that the audit delivers actionable intelligence rather than vague platitudes. Limiting the request to three items forces prioritization, aligning with the Pareto principle that roughly 80% of risk stems from 20% of issues.

 

The narrative format allows nuanced descriptions that standardized check-boxes might miss, such as "intermittent hydrogen sulfide release during tank draining." This detail is invaluable for industrial hygienists who must design controls or specify exposure-monitoring protocols.

 

Because the same auditor who rates conditions also documents concerns, the field creates a closed-loop narrative that justifies ratings and supports later dispute resolution if managers contest severity scores.

 

What immediate actions are recommended to address critical safety issues?

Requiring actionable recommendations converts the audit from a diagnostic tool into a change-management instrument. Mandatory completion ensures that every report leaves the reader with a concise task list, reducing the risk that findings will be shelved.

 

The open text accommodates both engineered solutions ("Install local exhaust ventilation at Station 3") and administrative ones ("Revise lock-out procedure to include second-line verification"), giving auditors flexibility while maintaining specificity. Over time, organizations can mine these statements to build a living database of effective countermeasures.

 

Because recommendations are time-stamped and linked to the auditor’s identity, accountability chains are clear, supporting post-audit verification visits and closure tracking.

 

What long-term improvements would enhance safety in this area?

While immediate actions target acute risks, this mandatory narrative field pushes auditors to think strategically—aligning with ISO 45001’s emphasis on continual improvement. Capturing long-term ideas (e.g., "Integrate IIoT sensors for predictive maintenance") creates a pipeline for capital planning and technology road-maps.

 

The field also signals to employees that leadership is open to multi-year investment, not just quick fixes, which can boost morale and participation in safety programs. Because the field is mandatory, organizations accumulate a portfolio of suggestions that can be evaluated for cost-benefit when budgets are allocated.

 

Analytics teams can later correlate long-term suggestions with incident reductions, building a business case that justifies larger safety expenditures to executive boards.

 

Auditor Signature

A digital or wet signature provides legal attestation that the report is accurate to the best of the auditor’s knowledge. Mandatory signing raises the psychological stakes, discouraging rushed or copy-paste assessments and reinforcing professional ethics.

 

In jurisdictions where audits are regulatory submissions, the signature satisfies evidentiary requirements and can be pivotal during enforcement appeals or insurance litigation. The signature field also creates a clear audit trail that supports ISO 45001 clause 9.2 on internal audit programme effectiveness.

 

User experience is streamlined because most e-form platforms allow mouse or stylus capture without leaving the browser, yet the symbolic weight remains high, underscoring the seriousness of the exercise.

 

Date of Signature

Coupled with the signature, the date field establishes the official close of the audit and starts the clock for regulatory deadlines (e.g., OSHA requires hazard abatement within 90 days). Mandatory entry prevents retro- or forward-dating that would misrepresent compliance timelines.

 

The date also underpins KPIs such as "audit cycle time," allowing safety managers to benchmark how quickly audits move from fieldwork to formal report. Over time, correlation analyses can reveal whether faster sign-off is linked to higher-quality findings or, conversely, to superficial assessments.

 

Because the field is auto-stamped in many digital systems, auditor burden is minimal while data integrity is maximized.

 

Summary of Weaknesses

Although the form is robust, three areas could be refined. First, the open-ended text fields for department names and locations risk inconsistent spelling; a lightweight auto-suggest or post-submission normalization step would improve data cleanliness. Second, the incident count question asks for raw numbers without distinguishing recordable injuries from near-misses; adding a brief instruction or sub-fields could enhance granularity without adding much complexity. Finally, the form lacks an explicit question about regulatory compliance status (e.g., OSHA citations pending), which would contextualize risk severity. These are minor enhancements that could be layered onto the existing structure without disrupting the proven user flow or analytic value.

 

Mandatory Question Analysis for Workplace Health and Safety Audit Form

Important Note: This analysis provides strategic insights to help you get the most from your form's submission data for powerful follow-up actions and better outcomes. Please remove this content before publishing the form to the public.

Mandatory Field Justifications

Organization Name
Mandatory capture is essential for multi-entity corporations where safety performance varies widely across subsidiaries. Without the legal entity name, trend data cannot be correctly aggregated or disaggregated for board-level dashboards, insurance renewals, or regulatory submissions such as OSHA 300-A logs. The field also prevents duplicate audits of the same organization under slightly different spellings, preserving data integrity.

 

Department/Unit Being Audited
This field localizes findings to an accountable managerial unit, enabling precise routing of corrective-action emails and resource-allocation decisions. Because departments often differ sharply in risk profiles (e.g., machining vs. marketing), omitting this identifier would render benchmarking analyses meaningless and obscure which line manager is responsible for follow-up.

 

Audit Location/Facility
Physical location determines which legal jurisdiction, union agreement, and emergency response protocol applies. Making this field mandatory guarantees that auditors cannot leave a vague reference such as "Main Plant," ensuring that any enforcement action or insurance claim can be tied to an unambiguous address and that IoT asset tags can be correctly mapped.

 

Audit Date
The date activates all temporal analytics, from rolling 12-month injury rates to compliance deadlines. A missing date would corrupt every downstream KPI dashboard and could invalidate regulatory submissions that require audit frequency demonstrations (e.g., ISO 45001 clause 9.2). Mandatory entry enforces chronological integrity and starts the clock for mandated abatement periods.

 

Auditor Name(s)
Legal attestation and professional accountability depend on knowing who conducted the assessment. A mandatory signature field without a corresponding name would be insufficient for dispute resolution, peer-review programs, or regulator inquiries. Capturing names also enables organizations to correlate auditor identity with action-closure rates, supporting continuous-improvement efforts.

 

Department/Area Manager
Safety ownership must reside with operational leadership, not corporate safety staff. By requiring the manager’s name, the form embeds accountability where budget and headcount decisions are made, increasing the likelihood that corrective actions will be resourced. Omitting this field would sever the link between findings and the individual with the authority to implement change.

 

Number of Employees in This Area
This integer converts raw incident counts into rates, enabling fair comparison across departments of differing sizes and supporting actuarial calculations that influence insurance premiums. Without it, a large area would always appear riskier than a small one, leading to misaligned priority setting and potentially higher premiums based on distorted risk perception.

 

Primary Activities/Operations in This Area
Activity descriptors allow risk-profiling algorithms to benchmark against industry codes and predefined hazard libraries. A mandatory entry prevents generic labels such as "Production" that would dilute inter-facility comparisons and impede predictive analytics aimed at identifying missing controls before incidents occur.

 

How many incidents (including near-misses) occurred in the past 12 months?
This metric quantifies recent safety performance and directly feeds key risk indicators used by insurers, regulators, and executive boards. Capturing near-misses surfaces latent conditions that could escalate into serious injuries. Making the field mandatory ensures that auditors cannot bypass the question, preserving data completeness for TRIR and LTIR calculations.

 

What are the top three safety strengths in this area?
Requiring documented strengths balances the audit’s tone, fostering managerial buy-in and creating a repository of best practices for enterprise-wide replication. A mandatory narrative prevents audits from becoming exclusively deficit-focused, which can demoralize staff and reduce cooperation during corrective-action implementation.

 

What are the top three safety concerns or hazards identified?
Mandatory disclosure ensures that every audit delivers actionable intelligence rather than vague observations. Limiting the request to three items forces prioritization, aligning resources with the 80/20 rule and providing industrial hygienists with the specificity needed to design targeted controls or exposure-monitoring protocols.

 

What immediate actions are recommended to address critical safety issues?
This field converts the audit from a diagnostic exercise into a change-management tool. A mandatory recommendations section guarantees that each report contains a concise task list, reducing the likelihood that findings will be shelved and providing a clear basis for post-audit verification and closure tracking.

 

What long-term improvements would enhance safety in this area?
While immediate actions target acute risks, this field aligns with ISO 45001’s continual-improvement mandate. Making it mandatory ensures that auditors propose strategic solutions (e.g., engineering upgrades or technology investments), creating a pipeline for capital planning and reinforcing the organization’s commitment to multi-year safety advancement.

 

Auditor Signature
Legal attestation that the report is accurate to the best of the auditor’s knowledge is non-negotiable for regulatory submissions, insurance claims, and internal audit programme effectiveness reviews. A mandatory signature raises professional stakes and discourages rushed or copy-paste assessments, reinforcing ethical responsibility.

 

Date of Signature
This field establishes the official close of the audit and starts the statutory clock for hazard-abatement deadlines (e.g., OSHA’s 90-day requirement). A mandatory date prevents retro-dating that would misrepresent compliance timelines and supports KPIs such as audit cycle time, enabling safety managers to benchmark report turnaround speeds.

 

Overall Mandatory Field Strategy Recommendation

The current strategy rightly keeps the majority of questions optional to minimize auditor fatigue while mandating only those fields essential for legal attribution, rate calculation, and actionable follow-up. This balance supports high completion rates without sacrificing the data required for regulatory compliance and corporate risk dashboards. To further optimize, consider auto-suggest normalization for text-based identity fields (Organization, Department, Location) to prevent spelling variants that complicate aggregation.

 

For future iterations, evaluate making the incident count field conditionally granular—auto-prompting for separate injury and near-miss boxes if the initial total exceeds zero—while keeping the aggregate mandatory. Finally, reinforce to auditors that optional narrative fields can be completed later during document review; marking them as "Save & Continue" rather than mandatory reduces perceived burden and encourages richer inputs once preliminary ratings are finalized.

 

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