EPIC Body Scanner Incident Report

Body Scanner Result Image

Fields marked with a * are required.

Airport:*
Date:* Time:
Gender: Age:
Ethnicity: Religion:
Name: Email:
Were you subject to (select all that apply):*
Magnometer (Metal Detector)
Body scanner
Pat-down (back of hand)
Pat-down (front of hand)
Other
Approx how long did it take to complete the screening? (Do not include time waiting in line)
If you underwent a body scan, please answer these questions:
     Were you verbally notified of an alternative to the body scanner? Yes No
     Did you see any signs that indicated you had an alternative? Yes No
If you were subject to a patdown, would you describe it as:
Overall evaluation:*
Comments:

Fields marked with a * are required.