Client Feedback Screen Result Form

CLIENT FEEDBACK SCREEN RESULT FORM

Provider Name:    Client Name:

Recitals

WHEREAS, Provider is engaged in offering feedback screening, user intake assessments, and related advisory services designed to capture client impressions, usability issues, and recommended actions; and

WHEREAS, Client requested that Provider perform a feedback screen of Client materials, product prototypes, or service interactions and produce a documented Result Form setting forth findings, ratings, and recommended remedial steps; and

NOW, THEREFORE, in consideration of the mutual covenants set forth in this form and any related Statement of Work executed by the parties, the parties record the results of the feedback screen and agree the following terms and conditions.

Feedback Screen Results

Date of Screen:    Facilitator:

Method: In-person Video Phone Remote testing

1. Clarity of content:   Notes:

2. Usability / navigation:   Notes:

3. Emotional response / tone:   Notes:

Confusing or ambiguous content Navigation or flow breakdown Accessibility concern Technical error or bug Other (describe below)

Scope of Work

The services to be performed by Provider are described below. Provider will perform the feedback screening and deliver a written Result Form and a follow-up recommendations summary in accordance with the scope specified.

Payment Terms

Total Fee:    Payment Schedule:

Term and Termination

Start Date:    End Date (if applicable):

Either party may terminate this engagement for material breach that remains uncured for the notice period above. Termination shall not relieve Client of its obligation to pay fees for work performed prior to termination, including reasonable costs incurred by Provider in winding down services.

Confidentiality

Each party acknowledges that in the course of performance it may receive Confidential Information of the other party. "Confidential Information" includes nonpublic business, technical, customer, and product information, feedback, and screening results. Each party agrees to (i) use Confidential Information solely for purposes of performing under this Agreement and the Result Form, (ii) restrict disclosure to its employees and contractors who need to know and who are bound by confidentiality obligations no less protective than those set forth herein, and (iii) take commercially reasonable measures to protect confidentiality. Confidential Information does not include information that is or becomes generally known to the public without breach by the receiving party, was known prior to disclosure, or is rightfully obtained from a third party free of obligation of confidentiality.

Governing Law

This Result Form and any disputes arising out of or relating to it will be governed by the laws of without regard to conflict of laws principles.

Entire Agreement

This Result Form, together with any attached Statement of Work or exhibits specifically incorporated by written reference, constitutes the entire agreement between the parties with respect to the feedback screening services and supersedes all prior and contemporaneous agreements, proposals, or communications, oral or written. Any amendment must be in a written document signed by authorized representatives of both parties.

Acknowledgment

The undersigned represent and warrant that they are authorized to execute this Result Form on behalf of the party for whom they sign and that the information recorded herein accurately reflects the feedback screen results and associated commercial terms agreed between the parties.

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