COMMENT CARD

As our customer, your opinions are valuable to us. Please take a few minutes and answer the following questions. Thank you.

GENERAL INFORMATION

First Name*
Last Name*
Email Address*
How did you hear about us?
Date of Visit [date date-727 date-format:mm/dd/yy first-day:0 placeholder "Click to select date."]
Server's Name

PLEASE RATE US ON THE FOLLOWING ITEMS

Quality of Service
 Excellent Good Ok Poor
Quality of Food
 Excellent Good Ok Poor
Quality of Drink
 Excellent Good Ok Poor
Atmosphere
 Excellent Good Ok Poor
Restaurant Cleanliness
 Excellent Good Ok Poor
Parking Availability
 Excellent Good Ok Poor
Value for Money
 Excellent Good Ok Poor
Overall Experience
 Excellent Good Ok Poor
Would you recommend us to a friend?
 Yes No

Additional Comments


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