Retail Assessment Failure Report Form
Report a retail assessment failure by providing the store details, failure observations, impact rating, and follow-up status.
Report Details
Assessment Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Store / Location Name or ID
*
Assessment Type
*
Scheduled Audit
Unannounced Visit
Follow-Up Review
Incident Inspection
Other
Failure Severity
*
Minor
1
2
3
4
5
6
7
8
9
Critical
10
1 is Minor, 10 is Critical
Failure Analysis
Impact / Urgency
*
Low
1
2
3
4
5
6
7
8
9
High
10
1 is Low, 10 is High
Failure Observations / Checkpoints
*
Primary Failure Category
*
Inventory
Pricing
Checkout/Payment
Staffing
Store Operations
Merchandising
System/Technology
Customer Service
Safety/Compliance
Other
What Failed and Where
*
Resolution And Follow-Up
Corrective Action Notes
*
Follow-Up Status
*
Open
In Progress
Resolved
Deferred
Other
Additional Follow-Up Comments
Submit Report
Should be Empty: