Alpha Sentinel Product Evaluation Form

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* 1. Account contact name:

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* 2. Thank you for taking part in the product trial for:

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* 3. Start date of trial:

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* 4. Finish date of trial:

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* 5. Product used for (e.g. removing asbestos):

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* 6. Name of business and address (including postcode):

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* 7. Industry or business:

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* 8. Name of person completing the form:

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* 9. Job title of person completing the form:

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* 10. Did you trial the mask personally or are you answering on behalf of someone else?

Myself

Someone Else

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* 11. If someone else, what is their job title:

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* 12. What was positive about your experience Alpha Sentinel:

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* 13. What was negative about your experience Alpha Sentinel:

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* 14. To what extent, if at all, are there differences to other products you have used like this before? Please state the product(s) and the differences:

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* 15. How could the product be improved:

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* 16. On a scale of 1–5, please rate the mask’s performance (5 = excellent)

	1	2	3	4	5
Appropriateness to task	Appropriateness to task 1	Appropriateness to task 2	Appropriateness to task 3	Appropriateness to task 4	Appropriateness to task 5
Weight	Weight 1	Weight 2	Weight 3	Weight 4	Weight 5
Field of vision	Field of vision 1	Field of vision 2	Field of vision 3	Field of vision 4	Field of vision 5
Comfort	Comfort 1	Comfort 2	Comfort 3	Comfort 4	Comfort 5
Compatibility with safety glasses	Compatibility with safety glasses 1	Compatibility with safety glasses 2	Compatibility with safety glasses 3	Compatibility with safety glasses 4	Compatibility with safety glasses 5
Misting of eyewear	Misting of eyewear 1	Misting of eyewear 2	Misting of eyewear 3	Misting of eyewear 4	Misting of eyewear 5
Strap adjustment	Strap adjustment 1	Strap adjustment 2	Strap adjustment 3	Strap adjustment 4	Strap adjustment 5
Inhalation resistance	Inhalation resistance 1	Inhalation resistance 2	Inhalation resistance 3	Inhalation resistance 4	Inhalation resistance 5
Exhalation resistance	Exhalation resistance 1	Exhalation resistance 2	Exhalation resistance 3	Exhalation resistance 4	Exhalation resistance 5
Inhaled air quality	Inhaled air quality 1	Inhaled air quality 2	Inhaled air quality 3	Inhaled air quality 4	Inhaled air quality 5
Cleaning and maintenance	Cleaning and maintenance 1	Cleaning and maintenance 2	Cleaning and maintenance 3	Cleaning and maintenance 4	Cleaning and maintenance 5
Overall	Overall 1	Overall 2	Overall 3	Overall 4	Overall 5
Range of filters	Range of filters 1	Range of filters 2	Range of filters 3	Range of filters 4	Range of filters 5
Consumption of filters	Consumption of filters 1	Consumption of filters 2	Consumption of filters 3	Consumption of filters 4	Consumption of filters 5

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* 17. Would you be happy to switch to this product? Y/N

Yes

No

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* 18. Please explain your answer:

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* 19. Can we publish any testimonials from the information provided? Y/N

Yes

No

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* 20. Your company name? Y/N

Yes

No

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* 21. Your job title? Y/N

Yes

No

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* 22. Your name? Y/N

Yes

No