Baseline Assessment Memorandum Acknowledgment Form
Please complete this form to acknowledge your review and understanding of the Baseline Assessment Memorandum.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Department or Team
*
Role/Position
*
Have you read and reviewed the Baseline Assessment Memorandum?
*
Yes, I have read and reviewed the memorandum.
No, I have not reviewed it yet.
How clearly did the memorandum communicate the baseline assessment findings?
*
1
2
3
4
5
Please indicate your level of agreement with the following statements regarding the memorandum.
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
The memorandum was easy to understand.
1
2
3
4
5
The memorandum addressed all relevant topics.
6
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9
10
The findings were presented objectively.
11
12
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I understand the implications of the assessment.
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If you have any questions or comments regarding the memorandum, please share them below.
Date of Acknowledgment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
I acknowledge that I have reviewed and understood the Baseline Assessment Memorandum.
*
I acknowledge
I do not acknowledge
Submit Acknowledgment
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