Restroom Queue Monitoring Form
Use this form to record current restroom queue conditions, usage, and any service or maintenance needs.
Restroom Location
*
Date and Time of Observation
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Current Queue Status
*
No queue
Short queue (1-3 people)
Moderate queue (4-7 people)
Long queue (8+ people)
Estimated Wait Time
*
No wait
Less than 5 minutes
5-10 minutes
More than 10 minutes
Queue Length (number of people waiting)
*
Current Occupancy (number of stalls/units in use)
*
Restroom Cleanliness
*
Excellent
Good
Fair
Poor
Supplies Status
*
Toilet paper available
Soap available
Paper towels available
Hand dryer working
All supplies fully stocked
Maintenance or Service Issues Observed
*
None
Clogged toilet
Overflow or leak
Broken dispenser
Unpleasant odor
Other
Additional Notes
Submit
Should be Empty: