Building Occupant Feedback Consent Form
Please provide your consent to participate in building feedback surveys and allow the use of your feedback to improve our facilities and services.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Unit/Apartment Number
*
Relationship to Building
*
Tenant
Owner
Employee/Staff
Other
How long have you occupied this unit?
*
Please Select
Less than 6 months
6 months to 1 year
1 to 3 years
More than 3 years
Preferred method to receive feedback surveys
*
Email
Phone/SMS
Paper form
May we contact you for follow-up questions about your feedback?
*
Yes
No
By signing below, you confirm that you have read and understood the consent information above and agree to participate in building feedback surveys.
*
Date of Consent
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Consent
Submit Consent
Should be Empty: