LEVR Demo Survey

PRIVACY STATEMENT We value your trust and will treat your responses as information that is private to you. The information we collect is used only to improve our products and services. If you choose to offer your contact information, it will never be shared or sold.
Start date of evaluation*
Date Format: MM slash DD slash YYYY
Name*
First Last
Email*
Phone*
Agency Name*
LEVR Serial Number
System Configuration*
- Hip Bag
- Jacket Cartridge
Test Location*
Descent Height (FT)*
Anchor Placement*
Shift-click to select multiple items.
Total number of descents*

Performance / Rappelling (determine if the descent is smooth and controllable)*
Difficult Fair Good
Controllable speed
Smooth descent
Ease of handling
Horizontal Travel / Pay-out*
Difficult Fair Good
Web feed
Edge / Sill Transition*
Difficult Fair Good
Overcoming Sill / Edges
Pack-ability and comfort as a hip carry bag*
Unsatisfactory Fair Good Not Applicable
Comfort
Pack-ability and comfort as a custom jacket cartridge (if applicable)*
Unsatisfactory Fair Good Not Applicable
Comfort
Summary regarding the LEVR Escape System
What if anything would you change about the system?

	Difficult	Fair	Good
Web feed

	Difficult	Fair	Good
Overcoming Sill / Edges

	Unsatisfactory	Fair	Good	Not Applicable
Comfort

	Unsatisfactory	Fair	Good	Not Applicable
Comfort

Carry comfort of LEVR Escape System (bag only)*
Difficult Fair Good
Hip Carry Bag
Custom Jacket Cartridge
Summary regarding the LEVR Escape Bag (bag only)
Is there anything else you would like to tell us?
That's It! Thank you for taking the time to participate in our survey. Your feedback is very important to us.
Please check the box below if we may share your feedback on the LEVR Escape System for promotional purposes.
- Yes, you may share!
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I am interested in (select all that apply):
- Rescue
- Access
Please enter your name and the date below as the electronic version of your signature.
Name*
First Last
Date*
Date Format: MM slash DD slash YYYY

	Difficult	Fair	Good
Hip Carry Bag
Custom Jacket Cartridge

Give us your demo feedback!