Information

  • Area Number:

  • Assessed By:

  • Conducted on:

  • State

  • Store Opening

  • Scheduled Audit

  • Unscheduled Audit

Audit Summary

  • Audit Scope:

  • Area(s) Covered:

  • Postzone(s)/Subsection(s):

  • List Catalogue(s) Audited:

  • Nominal Distribution Date:

Store Visit Details

  • Not Applicable

  • Date and Time of Visit:

  • Store Manager Name:

  • Customer Service Manager Name:

  • Store Manager Comments:

  • General Comments:

  • Store Opening Photos

General Findings - Audit Summary

  • Safety observations at location being audited?

  • Total Households Investigated:

  • Positive Responses:

  • Negative Responses:

  • Not Sure:

  • Not Home:

  • No Advertising Material Sign:

  • 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).

  • Additional Item 1

  • Additional Item 2

  • Additional Item 3

  • Additional Item 4

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