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Tell Us What You Think

Your comments are important to us

Date of Visit
Time

: HH

MM
Location*
Server
Number in Party
Rate Your Service
- A (Just Great!)
- B (Above Average)
- C (Average)
- D (Below Average)
- F (Poor)
Food Quality
- A (Just Great!)
- B (Above Average)
- C (Average)
- D (Below Average)
- F (Poor)
Menu Variety
- A (Just Great!)
- B (Above Average)
- C (Average)
- D (Below Average)
- F (Poor)
Hostess
- A (Just Great!)
- B (Above Average)
- C (Average)
- D (Below Average)
- F (Poor)
Atmosphere
- A (Just Great!)
- B (Above Average)
- C (Average)
- D (Below Average)
- F (Poor)
Comments
Food Items Ordered
First Visit?
- Yes
- No
Did a Manager Visit Your Table?
- Yes
- No
Did You Use Our Call Ahead Seating?
- Yes
- No
How Did You Hear of Us?
- T.V.
- Newspaper
- Friend
- Billboard
- Drive-By
- Publication
Would You Return and/or Recommend Us?
- Yes
- No
Name
First Last
Address
Street Address Address Line 2 City State ZIP Code
Phone Number
Email*