How often do you dine with us?
First Time                 Special Occasions
Once in a While                      Regularly

Please Tell Us About Your First Impression By Our Host Staff

	Excellent	Good	Fair	Poor
Friendly
Accuracy
Knowledgeable

Tell Us About Your Meal
Entree(s): 

	Excellent	Good	Fair	Poor
Quality
Presentation
Temperature

Tell Us About Your Server
Server's Name: 

	Excellent	Good	Fair	Poor
Friendly
Promptness
Accuracy
Attentive
Knowledgeable

Based on your experience, how likely are you to return and recommend us to others?
Definitely          Probably          Definitely Not

Name: 
Phone: 
Street: 
City:               State:     
Zip:      
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