Working Alone Monitoring System Account Info

WSBC has determined that SelfDesign MUST have a Lone Worker Monitoring Program implemented for ALL contractors (workers) it covers under WSBC. In order for SelfDesign to continue to operate, all such contractors (workers) MUST be trained in how to use this system when working alone. In this form, we gather the information and establish agreements for using the system. Please enter your information in order that we can set up an account for you in our monitoring system.

This information will be shared with OK Alone.
Their privacy policy is here: my.okalone.net/site/privacy.
SelfDesign has a contract addendum with OK Alone that states their company agrees to not sell your data to ANY third party.

THIS FORM CONTAINS PERSONAL INFORMATION and is only to be completed with necessary details. If you have any questions pertaining to the collection and use of your personal information please contact privacy@selfdesign.org.

Name *

First

Last

Phone *

Alternate Phone Number

Email *

Work Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

If there is no regular place you work from, then please add your home address

Other personal identifying information, useful in the case of an emergency (e.g. licence plate number)

Please list the names and phone numbers with area code of those whom you are most in touch with on a daily basis. The first contact should be the one you are closest with. For example, the first contact might be your spouse. Another contact might be someone you work with, or neighbour. Contacts who can check on you in the event of an emergency are ideal.

Emergency Contact #1: FULL NAME *

Emergency Contact #2: FULL NAME *

Emergency Contact #3: FULL NAME

Emergency Contact #1: PHONE *

Emergency Contact #2: PHONE *

Emergency Contact #3: PHONE *

We recommend copying the text below and emailing it to each Emergency Contact:

Hello!I have added you as an Emergency Contact in a system that prompts me to check in when I am working alone. This is because sometimes I offer services in areas where there is no one trained to assist me if I become ill or injured.If I become unresponsive during one of the periods when working alone, the system will attempt to call me, and if it is unsuccessful in reaching me, then it will try calling each of my three designated emergency contacts. If you are called by the monitoring system, it would be helpful if you could try to get a hold of me to ask me to check in to the system. It does not necessarily mean that I am ill or injured, and there is a chance it may not reflect an actual emergency. There are mechanisms in place beyond the call that you receive to find me, so if you miss the call or cannot get a hold of me, other efforts will still be made. If you do not wish to be an emergency contact, please let me know. Thank you for your help! - Your Name and phone number

Workers can use an app on their smartphone to manage their check-ins; OR, workers can call in on their phone to the monitoring system to check-in, which can be useful for workers without a smartphone. Both systems are paid for by SelfDesign.

Please choose the lone worker monitoring method that will work best for you *

Smartphone App - you have a smartphone, and you will use the app to check-in
Phone Call Check-ins - you will call or send an SMS/text to a phone number that will be provided in order to check in to the system (no smartphone required)

WSBC has determined that SelfDesign MUST have a Lone Worker Monitoring Program implemented for ALL contractors (workers) it covers under WSBC. In order for SelfDesign to continue to operate, all such contractors (workers) MUST be trained in how to use this system when working alone. In order to continue operating, we ask for the following agreements:

I have read the Lone Worker Monitoring introduction and definition, and I agree to activate the lone worker system. *

Yes

I understand that it is my responsibility to use this system. If, after reading the forthcoming instructions and FAQ I do not understand how to use it, I will email worksafe@selfdesign.org. *

Yes

Once in the activated system, whenever there is an update to my emergency contact information I will email the update to SelfDesign at worksafe@selfdesign.org *

Yes