Feedback Form

1. Your Name (optional)
2. Your Organisation (optional)
3. Your Contact Details (optional)
4. Your Affiliation (optional)
Further Details
5. The Service/Facility/Project/Group/Person/Experience or Interaction this feedback relates to *MANDATORY*
Further details
6. Your contact person(s) at the Institute for Envoronmental Research (IER) (optional)
7. Email address of any person at ANSTO you would like a copy of this Feedback Form sent to (optional)
8. The experience/interactions that this feedback relates to	1 (poor) 2 (average) 3 (satisfactory) 4 (good) 5 (excellent)
9. The quality of scientific/technical aspects of your experience/interaction	1 (poor) 2 (average) 3 (satisfactory) 4 (good) 5 (excellent)
10. The interaction with staff	1 (poor) 2 (average) 3 (satisfactory) 4 (good) 5 (excellent)
11. The timeliness of your experience/interaction	1 (poor) 2 (average) 3 (satisfactory) 4 (good) 5 (excellent)
12. The degree to which your expectations were met	1 (poor) 2 (average) 3 (satisfactory) 4 (good) 5 (excellent)
13. If you have dealt with us before, was your experience this time	1 (poor) 2 (average) 3 (satisfactory) 4 (good) 5 (excellent)
14. Other aspects related to your experience/interaction?
15. Would you recommend or repeat this experience/interaction again?	Yes No
16. Any other comments and/or suggestions?


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