Facility Visit Readiness Quiz
Check your preparedness for your upcoming facility visit by answering the questions below.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Department or Group
Have you previously visited this facility?
*
Yes
No
Rate your familiarity with the facility’s safety procedures.
*
1
2
3
4
5
Which of the following personal protective equipment (PPE) are you required to bring?
*
Safety helmet
Safety glasses
High-visibility vest
Steel-toe boots
Other
Please indicate your agreement with the following statements about facility rules.
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I understand the facility’s visitor rules
1
2
3
4
5
I know the emergency exit locations
6
7
8
9
10
I am aware of restricted areas
11
12
13
14
15
I will follow all instructions from facility staff
16
17
18
19
20
If there is an emergency, what is the first action you should take?
*
Alert facility staff immediately
Try to resolve the situation yourself
Leave the facility without notifying anyone
Other
List any questions or concerns you have before your visit.
How confident are you in your readiness for the facility visit?
*
Not confident
1
2
3
4
Very confident
5
1 is Not confident, 5 is Very confident
Please provide the date of your scheduled visit.
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Quiz
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