Posted By Kieran J Duignan Rick Your request leaves me wondering whether your 'GM' understands what he is asking you to do. Normally, a questionnaire is used to gather data or opinions about various attributes of people or things. Within a behavioural safety programme, you could use a variety of questionnaire for this purpose. Without details of the objectives, resources and timeschedule of your behavioural safety programme, it seems to me to be impossible to respond to your request. On the basis of the information you've given, the only kind of questionnaire I can think of is one for you to give to senior maangement, asking their opinions about their commitment to a behavioural safety programme, as the basis on which you can then start to plan.