Testing - Survey 2

Interior Design Evaluation Survey

Gender: M F
Age: 14-16 17-19 20-30 31-40 41-50 51-60 61-70 71-80

Please answer the following questions as if you were a patient coming into the clinic. For each question circle the number 1-10 that corresponds with your opinion. 10 is the highest and 1 is the lowest.
1. I would feel comfortable in the waiting room
1 2 3 4 5 6 7 8 9 10

2. The colors and theme of the waiting room are calming
1 2 3 4 5 6 7 8 9 10

3. The finishes and materials chosen for the room are appropriate
1 2 3 4 5 6 7 8 9 10

4. The artwork is fitting
1 2 3 4 5 6 7 8 9 10

5. The television is appropriately placed for viewing
1 2 3 4 5 6 7 8 9 10

6. The separation of the children’s area and general waiting area is beneficial
1 2 3 4 5 6 7 8 9 10