Feedback Summary Form

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Feedback Summary Form

For completion by Proposal Sponsor/Responsible Administrator after vetting process is complete.

ARP Number:*

ARP Title:*

Name Proposal Sponsor/Responsible Administrator*

First Name

Last Name

Email*

Review/Comment Period:

(mm/dd/yyyy - mm/dd/yyyy) format

Number of Feedback Submissions to summarize

Select options based on number of surveys or categories.

Summary 1

Date Feedback Received

Stakeholder

Proposal modified based on feedback?

Yes No

Summary of Feedback Received

Explanatory comments including cite to policy where change made in response to feedback.

Other

Summary 2

Date Feedback Received

Stakeholder

Proposal modified based on feedback?

Yes No

Summary of Feedback Received

Explanatory comments including cite to policy where change made in response to feedback.

Other

Summary 3

Date Feedback Received

Stakeholder

Proposal modified based on feedback?

Yes No

Summary of Feedback Received

Explanatory comments including cite to policy where change made in response to feedback.

Other

Summary 4

Date Feedback Received

Stakeholder

Proposal modified based on feedback?

Yes No

Summary of Feedback Received

Explanatory comments including cite to policy where change made in response to feedback.

Other

Summary 5

Date Feedback Received

Stakeholder

Proposal modified based on feedback?

Yes No

Summary of Feedback Received

Explanatory comments including cite to policy where change made in response to feedback.

Other

Summary 6

Date Feedback Received

Stakeholder

Proposal modified based on feedback?

Yes No

Summary of Feedback Received

Explanatory comments including cite to policy where change made in response to feedback.

Other

Summary 7

Date Feedback Received

Stakeholder

Proposal modified based on feedback?

Yes No

Summary of Feedback Received

Explanatory comments including cite to policy where change made in response to feedback.

Other

Summary 8

Date Feedback Received

Stakeholder

Proposal modified based on feedback?

Yes No

Summary of Feedback Received

Explanatory comments including cite to policy where change made in response to feedback.

Other

Summary 9

Date Feedback Received

Stakeholder

Proposal modified based on feedback?

Yes No

Summary of Feedback Received

Explanatory comments including cite to policy where change made in response to feedback.

Other

Summary 10

Date Feedback Received

Stakeholder

Proposal modified based on feedback?

Yes No

Summary of Feedback Received

Explanatory comments including cite to policy where change made in response to feedback.

Other

Summary 11

Date Feedback Received

Stakeholder

Proposal modified based on feedback?

Yes No

Summary of Feedback Received

Explanatory comments including cite to policy where change made in response to feedback.

Other

Summary 12

Date Feedback Received

Stakeholder

Proposal modified based on feedback?

Yes No

Summary of Feedback Received

Explanatory comments including cite to policy where change made in response to feedback.

Other

Summary 13

Date Feedback Received

Stakeholder

Proposal modified based on feedback?

Yes No

Summary of Feedback Received

Explanatory comments including cite to policy where change made in response to feedback.

Other

Summary 14

Date Feedback Received

Stakeholder

Proposal modified based on feedback?

Yes No

Summary of Feedback Received

Explanatory comments including cite to policy where change made in response to feedback.

Other

Summary 15

Date Feedback Received

Stakeholder

Proposal modified based on feedback?

Yes No

Summary of Feedback Received

Explanatory comments including cite to policy where change made in response to feedback.

Other