Start for free
Safety · Form

Sample Form: ارزیابی مانور آتش‌نشانی

ناظر: زمان تخلیه، عملکرد مسئولان طبقات، مشکلات مسیر و نمره‌ی کلی.

7 questions · Free up to 50 responses a month

Build a form from this templateDownload WordDownload PDFAll templates

Print-ready Word and PDF files — free, no sign-up.

About this template

“ارزیابی مانور آتش‌نشانی” has 7 questions; 4 are required and 3 optional. Question types: Number (2), Date (1), Short text (1), Single-choice matrix (1), Long text (1), Star rating (1). The matrix question “بررسی” rates 5 items on a 3-point scale from “بله” to “تا حدی”.

In the online version of this template

  • Dates are picked and stored on the Jalali (Persian) calendar.
Related:Online form builder

Questions in this template

  1. 1.

    تاریخ مانور *

    (Date)
  2. 2.

    ساختمان *

    (Short text)
  3. 3.

    زمان تخلیه‌ی کامل (ثانیه) *

    (Number)
  4. 4.

    تعداد افراد

    (Number)
  5. 5.

    بررسی *

    (Single-choice matrix)

    Items: آژیر شنیده شد، مسیرها باز بود، مسئولان طبقه حاضر بودند، سرشماری انجام شد، آسانسور استفاده نشد

    Scale: بله، خیر، تا حدی

  6. 6.

    مشکلات مشاهده‌شده

    (Long text)
  7. 7.

    نمره‌ی کلی

    (Star rating)

Printable or online?

Printable version (Word & PDF)

  • For filling in on paper, signing and filing by hand
  • Edit the Word file any way you like
  • Collecting and typing up the answers is up to you
Download WordDownload PDF

Online version on Porsino

  • Answers are collected and organised automatically — no retyping
  • National ID, mobile number and dates are validated instantly
  • Ready-made reports and charts, plus Excel export in one click
  • Share a link or QR code — it works on mobile too
Build the online version for free

How do I use this template?

  1. Sign up for Porsino for free; no bank card needed.
  2. In the panel, open “Templates” and choose “ارزیابی مانور آتش‌نشانی”.
  3. Change the questions as you like, publish the form and send the link.

Related Safety templates

All Safety templates