Self-Checkout Audit Form
Complete this form to audit the condition and performance of a self-checkout machine or area.
Auditor Name
*
First Name
Last Name
Date and Time of Audit
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Self-Checkout Location or Machine ID
*
Is the self-checkout area clean and tidy?
*
Yes
No
Needs Attention
Are all self-checkout machines operational?
*
All operational
Some not working
None operational
Is appropriate signage and guidance visible for customers?
*
Clear and visible
Partially visible
Not visible
Are security and anti-theft measures in place and functioning?
*
Yes
No
Not applicable
Are all supplies (bags, receipt paper, etc.) stocked?
*
Fully stocked
Low stock
Out of stock
How would you rate customer flow and queue management?
*
1
2
3
4
5
Comments or issues observed
Overall Audit Rating
*
1
2
3
4
5
Submit Audit
Should be Empty: