Because we care, we would like to know….

Date of your visit (MMDDYY):
Time of visit:
Was your visit for:	-select- Lunch Dinner To Go Other
Number in your party:
Please rate your first impression:
Greeting:	-select- Excellent Very Good Good Fair Poor
Table Area:	-select- Excellent Very Good Good Fair Poor
Cleanliness:	-select- Excellent Very Good Good Fair Poor
What did you order?
	Burger Wings Hot Dog Chicken Sandwich Salad Daily Special Veggie Burger Oven Roasted Sandwich
Tell us about your meal:
Quality:	-select- Excellent Very Good Good Fair Poor
Temperature:	-select- Excellent Very Good Good Fair Poor
Appearance:	-select- Excellent Very Good Good Fair Poor
Entrée(s):	-select- Excellent Very Good Good Fair Poor
How often do you dine with us?:	-select- First time Once in a while Regularly
How was our service?:
Courteous:	-select- Excellent Very Good Good Fair Poor
Prompt:	-select- Excellent Very Good Good Fair Poor
Accurate:	-select- Excellent Very Good Good Fair Poor
How do our prices compare to the food & service?	-select- About right Lower than Expected Too High
Based on your visit today, how likely are you to recommend us to others?	-select- Definitely Probably Definitely Not
What could we do to better serve you?
Name:	(required)
Address:
Email:	(required)
Phone:
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We greatly appreciate your time and feedback.
All information is confidential and will not be given to any third party.