Preventive Maintenance Questionnaire
This questionnaire is designed to assess current maintenance practices and identify opportunities for improving preventive maintenance processes and equipment reliability.
Respondent Information
Name
First Name
Last Name
Job Title
Department
Email
example@example.com
Equipment Information
Equipment/Asset Name
Equipment ID
Location
Type of Equipment
Please Select
Mechanical
Electrical
HVAC
IT Equipment
Other
Maintenance Practices
Do you currently follow a preventive maintenance schedule?
Yes
No
How often is maintenance performed?
Please Select
Daily
Weekly
Monthly
Quarterly
Annually
Is maintenance documented?
Yes
No
Are maintenance checklists used?
Yes
No
Performance & Reliability
How would you rate equipment reliability?
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Frequency of breakdowns
Please Select
Rare
Occasional
Frequent
Very Frequent
Average downtime per incident
Please Select
Less than 1 hour
1–4 hours
4–8 hours
8+ hours
Issues & Challenges
Common maintenance issues
Challenges in performing preventive maintenance
Are spare parts readily available?
Yes
No
Resources & Tools
Do you have adequate tools and resources?
Yes
No
Are maintenance staff properly trained?
Yes
No
Maintenance management system used
Improvement Opportunities
Suggestions for improving maintenance processes
Areas needing immediate attention
Final Section
Additional comments
Submit
Should be Empty: