Information
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Area Number:
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Assessed By:
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Conducted on:
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State
- NSW
- Vic
- Qld
- SA
- WA
- Other
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Store Opening
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Scheduled Audit
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Unscheduled Audit
Audit Summary
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Audit Scope:
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Area(s) Covered:
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Postzone(s)/Subsection(s):
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List Catalogue(s) Audited:
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Nominal Distribution Date:
Store Visit Details
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Not Applicable
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Date and Time of Visit:
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Store Manager Name:
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Customer Service Manager Name:
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Store Manager Comments:
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General Comments:
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Store Opening Photos
General Findings - Audit Summary
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Safety observations at location being audited?
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Total Households Investigated:
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Positive Responses:
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Negative Responses:
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Not Sure:
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Not Home:
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No Advertising Material Sign:
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Other (No access, locked gate, dangerous dog):
Summary of Investigation (DVU checks attached)
General Comments (Optional. Comments on any identified positives or concerns not noted above).
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Additional Item 1
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Additional Item 2
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Additional Item 3
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Additional Item 4