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Test Feedback Form

SAFETY GLASSES

Date: ___________________________________

Initiated By: ____________________________

Glass Ref#: _____________________________

Glass Features: Anti Fog Anti-Scratch Polarized Other ______________________

Lens Color: Clear Tinted Grey Yellow Other ____________________________

WEARER TRIAL INFO


Wearer’s Name: _______________________________________________ Work Type/Application: ___________________________________

Wearer Trial Date: ______________(Start) / ________________(End) Current Glass Brand: _____________________________________

Wearer Trial Location: ___________________________________________ Current Glass Ref: ______________________________________

TEST PARAMETERS
Compared to your Current
Glass
Excellent Good Average Poor N/A Inferior Equal to Better
A) Performance Performance
Anti-Fog
Anti-Scratch
Vision/Visibility
B) Fitting Fitting
Fit/Sizing
Sliding or Slipping Control
Style
Closing (minimum gap with face)
C) Comfort Comfort
Nose Piece
Pressure from Sidearms
Eyewear Weight

Samples Returned
We highly recommend that you send back sample to Milwaukee, after trials, for analysis

Comments/Suggestions: ______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________________________

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