Sensory Project Questionnaire

URL

This field is for validation purposes and should be left unchanged.

Organization Name(Required)

State / Province(Required)

Name (Project Leader)(Required)

Position/Role(Required)

Phone Number(Required)

Project Assistant (If applicable, enter Name/Role/Phone/Email)

Project Start Date

If unknown, estimate an anticipated start or funding date.

Completion Date

Date you hope to have the project completed.

Budget Amount

Actual or estimated maximum budget.

Briefly describe the purpose of the project:

Facility Type(Required)

Are there individuals who are blind?(Required)

Are there individuals who are deaf?(Required)

Are there individuals in wheelchairs?(Required)

Additional Information

Sensory Space Objectives Indicate the level of importance of each objective on a 1-5 scale (1 being least important & 5 most important).

What are the major physical and cognitive challenges of users?

Room Specifications(Required)

Enter the following information above accompanied by a sketch (attach file). It can be a simple hand-drawn sketch or computer generated. Ensure the following details are answered/included:

The dimensions of the room.
The height of ceiling from the floor.
The location of the doors and the direction they open.
The location of all windows in the room and their dimensions.
The location of permanent fixtures and furniture to remain in the room.
Permanent fixtures attached to the walls (Lights, Pipes, Heaters, Vents, A/C units, etc.)
The location of all the wall plugs in the room. Please indicate if they are single or double plugs and their distance from the floor.
What type of lighting is in the room? Florescent or incandescent light bulbs etc.? How many?
Do the light fixtures hang down from the ceiling? If so, how far? What is their location on the ceiling.
What is the construction of the ceiling? Cement, Drywall or Drop Tile?
Indicate the locations of any permanent ducts, pipes or obstructive objects on the walls or ceiling.

File

Drop files here or

Max. file size: 25 MB, Max. files: 4.

Additional Information/Comments

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Professional Sensory Equipment

Interactive Projection for Sensory Spaces

Enhance Any Sensory Space

Transform Any Space With Interactive Projection

Professional Sensory Equipment

Interactive Projection for Sensory Spaces

Enhance Any Sensory Space

Transform Any Space With Interactive Projection

Sensory Project Questionnaire

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