Document Reference: TW-168
No Exit Survey
TW-168 is stored in a sealed opaque folder. Personnel may not read it. Transfer requires a written log of recipient. It is currently used in Level 5 psychological evaluation under Director authorisation only.
TW-168 is a printed questionnaire, 4 pages, 22 questions, that cannot be stopped once begun. Individuals who read question 1 feel compelled to answer it and continue. The questionnaire cannot be put down until completed. Most subjects complete it in 12–15 minutes. Subjects who resist report severe distress. The questions become increasingly personal and specific to the respondent's life as the questionnaire progresses, despite being printed generically. No two completed questionnaires are the same. The final question is different for every respondent.
TW-168 was found in a waiting room. The receptionist had filled it out along with every patient who had passed through that day — 14 people — none of whom remembered picking it up.
No incident reports on file.