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Request a Visit

If you are a small business in Northern Ireland (less than 50 employees) and you would like to request a free and confidential health and safety advisory visit, please complete this form and submit it to us.  We will then contact you to arrange a suitable date and time.

Indicates required information

Your details

Contact Name: 

Name of Company: 

Address: 

Postcode: 

Position in Company: 

Telephone Number: 

Mobile Number: 

Email Address: 

Type of Business: 

Total Number of Employees: 

How did you hear about us: 

Are there any specific health and safety issues you would like to discuss during the visit?
If yes, please specify:
(plain text only, 750 character limit)