Research Study Environment Feedback Report
Please provide your feedback on the research study environment to help us improve future research experiences.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Role in the Research Study
*
Please Select
Participant
Observer
Researcher/Staff
Other
Study Title or Identifier
*
Date of Feedback
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Please rate the following aspects of the research environment:
*
Rows
Excellent
Good
Fair
Poor
Cleanliness
1
2
3
4
Noise Level
5
6
7
8
Lighting
9
10
11
12
Equipment Availability
13
14
15
16
Temperature/Comfort
17
18
19
20
Overall, how would you rate your experience in the research environment?
*
1
2
3
4
5
Did you encounter any of the following issues? (Select all that apply)
Uncomfortable temperature
Insufficient equipment
Noise disturbances
Poor lighting
Cleanliness concerns
Other (please specify)
What resources or support did you find most helpful during the study?
What suggestions do you have for improving the research study environment?
Additional comments or feedback
Submit Feedback
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