Lighting Survey Form
Lighting Survey Form – Please provide feedback about your current lighting environment to help us improve quality and comfort.
Survey Location (Room or Area Name)
*
Type of Area
*
Please Select
Office
Conference Room
Hallway
Restroom
Break Room
Other
Current Lighting Type
*
LED
Fluorescent
Incandescent
Halogen
Other
Is the lighting adequate for your tasks?
*
Yes
No
Sometimes
How would you rate the overall brightness?
*
1
2
3
4
5
How would you describe the color temperature of the lighting?
*
Cool (bluish)
Neutral (white)
Warm (yellowish)
Not sure
Do you notice any glare or reflections from the lighting?
*
Yes
No
Sometimes
Please rate your satisfaction with the following aspects of the lighting:
*
Rows
Very Dissatisfied
Dissatisfied
Neutral
Satisfied
Very Satisfied
Brightness
1
2
3
4
5
Color Quality
6
7
8
9
10
Distribution
11
12
13
14
15
Glare Control
16
17
18
19
20
Are there any areas where lighting should be improved?
Additional comments or suggestions
Submit Lighting Survey
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