Cleanliness Initiative Feedback
Help us improve by sharing your feedback on our cleanliness initiative.
Your Name (optional)
Email Address (optional)
example@example.com
What is your primary role or relationship to this facility?
*
Please Select
Employee
Visitor
Resident
Student
Other
Which area(s) are you providing feedback on?
*
Restrooms
Hallways/Common Areas
Offices/Workspaces
Cafeteria/Dining Areas
Outdoor Spaces
Other
How satisfied are you with the overall cleanliness of the facility?
*
1
2
3
4
5
Please rate the following aspects of cleanliness:
*
Rows
Very Poor
Poor
Average
Good
Excellent
Restrooms
1
2
3
4
5
Hallways/Common Areas
6
7
8
9
10
Offices/Workspaces
11
12
13
14
15
Cafeteria/Dining Areas
16
17
18
19
20
Outdoor Spaces
21
22
23
24
25
How often do you notice the facility being cleaned?
*
Multiple times a day
Once a day
A few times a week
Rarely
Never
Have you observed any cleanliness issues recently?
*
Yes
No
If yes, please describe the issues you observed.
How satisfied are you with the attitude and professionalism of the cleaning staff?
*
Very Dissatisfied
1
2
3
4
Very Satisfied
5
1 is Very Dissatisfied, 5 is Very Satisfied
What suggestions do you have for improving cleanliness in the facility?
Any additional comments or feedback?
Submit Feedback
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