| Participant's signin information | |
|---|---|
| First Name | MAN |
| Middle | |
| Last Name | Test |
| Test Serial# | OAK1_0002 |
| Test Date | 11/13/2003 |
| Number of times participant played each recording | |
|---|---|
| Item directions | 0 |
| Question | 1 |
| Option 1 |
|---|
| On criterion | The rating was | weighted by | Giving a score of |
|---|---|---|---|
| WHO (person reporting) | 5 out of 5 | 2 | 2 |
| WHERE (location of problem) | 5 out of 5 | 3 | 3 |
| WHAT (nature of problem) | 5 out of 5 | 5 | 5 |
| WHEN (time or date of occurrence) | 5 out of 5 | 3 | 3 |
| WHY / HOW / PURPOSE | 5 out of 5 | 7 | 7 |
| Total score: | 20 | ||
|