Report evaluation form

REPORT EVALUATION FORM TO: Report Recipient                DATE:                             To assist in reducing the volume of paperwork, your evaluation of this report is needed. Please check the item below that, for you, best describes the attached report copy--

[ ] 1. I don't really need this report; please discontinue it.	[ ] 5. I need the report as is; please continue it. (I keep it on hand for __ months.)
[ ] 2. I need the information in the report but could obtain it from a reference copy if one were made in my general area.	Additional comments on Item No. :
[ ] 3. I need the information, but on a less frequent basis.  I would like a copy (circle one): weekly     monthly   quarterly     annually
[ ] 4. I need this report, but it would be much more useful if the report could be modified in format or content.

Date:

Your name:

Department:

Note: If you wish to continue to receive this report, you must respond within 10 days.