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Appendix: Site Survey ReadinessChecklist and Survey Form

Presurvey (Readiness) Checklist (much of this information should already be in the statement of work)

Location:_________________________________________________

________________________________________________________

Address, City, State, Zip:

Can equipment be shipped to this location? Yes __ No __

Name of Recipient: _________________________________________

If no, what is the shipping address? Yes __ No __

________________________________________________________

Address, City, State, Zip:

Location Contact Information

Managerial Name:

Title:

Phone:

Mobile:

Fax:

E-mail:

Available ...

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