OMB Control # 1910-XXXX
Exp. Date
Lighting Survey
[L Prize Partner] would like to know what you think about the lighting in this area. This questionnaire is entirely voluntary. Your responses will be aggregated with those of others and no individual responses or other identification will be reported.
Date of Survey: _________________________________
Respondent Category – Please select one of the following that best describes you:
Lighting or design professional (including lighting designer, interior designer, architect, lighting showroom staff, etc.)
Facility or institutional manager (or others who select/purchase large quantities of lighting products)
General consumer (select/purchase lighting products primarily for personal home use)
Public reporting burden for this collection of information is estimated to average 13 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Office of the Chief Information Officer, Records Management Division, IM-23, Paperwork Reduction Project (1910-XXXX), U.S. Department of Energy, 1000 Independence Ave SW, Washington, DC, 20585-1290; and to the Office of Management and Budget (OMB), OIRA, Paperwork Reduction Project (1910-XXXX), Washington, DC 20503.
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Too dim |
Somewhat dim |
Just right |
Somewhat bright |
Too bright |
1 |
2 |
3 |
4 |
5 |
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Too cool (very blue) |
Somewhat cool (blue) |
Just right (neither too cool nor too warm) |
Somewhat warm (yellow) |
Too warm (very yellow) |
1 |
2 |
3 |
4 |
5 |
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Negative Impact |
Neutral Impact |
Positive Impact |
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1 |
2 |
3 |
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Definitely would not recommend |
Would not recommend |
May or may not |
Would recommend |
Definitely would recommend |
1 |
2 |
3 |
4 |
5 |
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Flickering |
Glare |
Odd color |
Uneven lighting |
Other |
1 |
2 |
3 |
4 |
5 |
Please describe any problems you notice: |
File Type | application/msword |
File Title | December 14, 2007 |
Author | Bruce Kinzey |
Last Modified By | crutcev |
File Modified | 2012-07-18 |
File Created | 2012-07-18 |