… your opinion matter
Customer Service Survey
Name
*
Name
First Name
First Name
Last Name
Last Name
Phone Number
*
E-mail
*
Dine in / Take Out
*
Dine in
Take Out
Day Visited
*
Time
12
1
2
3
4
5
6
7
8
9
10
11
:
00
05
10
15
20
25
30
35
40
45
50
55
AM
PM
Food Quality
*
Excellent
Good
Average
Dissatisfied
Overall Service Quality
*
Excellent
Good
Average
Dissatisfied
Cleanliness
*
Excellent
Good
Average
Dissatisfied
Order Accuracy
*
Excellent
Good
Average
Dissatisfied
Speed of Service
*
Excellent
Good
Average
Dissatisfied
Value
*
Excellent
Good
Average
Dissatisfied
Overall Experience
*
1 Star
2 Stars
3 Stars
4 Stars
5 Stars
Any comments, questions or suggestions?
If you are human, leave this field blank.
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