AGED CARE CHANNEL- SITE SURVEY<br><br>

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CONTACT DETAILS<br>
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Company: [[Company]]<br>
Organisation Name: [[OrganisationName]]<br>

Street Address: [[StreetAddress]]<br>
Suburb: [[Suburb]]<br>
State: [[State]]<br>
PostCode: [[PostCode]]<br>

Contact Name: [[ContactName]]<br>
Telephone: [[Telephone]]<br>
Email: [[Email]]<br>

Position: [[Position]]<br>

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EQUIPMENT & BUILDING DESCRIPTION<br>
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Name of the room to be connected to the Aged Care Channel: [[RoomName]]<br><br>
Is there a TV in the room? [[IsTV]]<br><br>
Is there a DVD RECORDER in the room? [[IsDVD]]<br><br>
When will the TV / DVD RECORDER be in the designated room? [[WhenTV]]<br><br>
Age of Building: [[AgeBuilding]]<br><br>
Number of Storeys: [[NoStoreys]]<br><br>
What floor is the room on? [[RoomFloor]]<br><br>
What is the roof material above the designated room? [[RoofMaterial]]<br><br>
How does the installer access the roof? [[RoofAccess]]<br><br>
Is there a powerpoint in the designated room? [[IsPpt]]<br><br>
Are there any OHS requirements the installer must comply with? [[OHS]] [[OHSDetails]]<br><br>
Does the facility have Satellite Pay TV? [[PayTV]]<br><br>
Is there heritage listing on any part of the building? [[HeritageLstg]]<br><br>
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