Safety Rest Area and Welcome Center comment form

*required information


Name:

*E-mail address:

Address:


City:

State:

ZIP Code:

Telephone:


Date:

Time of visit:

Areas of Evaluation

Personnel (available, helpful, polite, etc?)
Poor
Fair
Average
Good
Excellent


Facility cleanliness
Poor
Fair
Average
Good
Excellent


Supplies (toilet paper, soap, maps, etc.)
Poor
Fair
Average
Good
Excellent


Grounds/parking lot cleanliness
Poor
Fair
Average
Good
Excellent




 

Page last modified: Oct. 14, 2012