Name

Location

Email

Phone

Server Name

Date of Visit

Friendliness of Host Staff

Friendliness of Server

Friendliness of Staff

Was Your Bartender Friendly?

How Was the Flavor of Your Meal?

Did You Receive a Good Value?

Was the Temperature of Your Food What You Expected?

Did You Take Any Food Home?

How Was Your Margarita?

Was Your Beer Cold?

Did You Have Enough Selections to Choose From?

Were Refills Delivered in a Timely Fashion?

How Would You Rate Your Visit?

Was the Manager Visible?

Did the Manager Visit Your Table?

How Often Do You Visit Us in a Month?

Additional Information