Annual Site Visit Feedback
Please provide your feedback on your recent annual site visit. Your input helps us improve our sites and operations.
Site Name or Location
*
Date of Visit
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Your Full Name
*
First Name
Last Name
Your Email Address
*
example@example.com
Purpose of Visit
*
Please Select
Routine Inspection
Safety Audit
Maintenance Review
Other
Please rate the following aspects of the site:
*
Rows
Excellent
Good
Fair
Poor
Cleanliness
1
2
3
4
Safety Compliance
5
6
7
8
Equipment Condition
9
10
11
12
Signage & Information
13
14
15
16
Staff Professionalism
17
18
19
20
How satisfied were you with your overall experience?
*
1
2
3
4
5
Were any issues or hazards observed during the visit?
*
No issues observed
Minor issues observed
Major issues observed
Please describe any issues, hazards, or areas needing attention (if any):
What are the site's strengths or positive aspects?
Suggestions for improvement or additional comments:
Would you like to be contacted for follow-up regarding your feedback?
*
Yes, please contact me
No, follow-up not needed
Signature
*
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