Restaurant Survey Form

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1/9 EXAMPLES

Text in this Example:

Please help us learn
what we're doing right and
what we need more work
on by filling out this card
How many in your party?
Date
Dine in
Take out
Breakfast
Lunch
Dinner
The name of your server:
What did you order?
Quality of food:
Excellent
Good
Fair
Poor
Portion size:
Ease of Ordering:
Service:
Cleanliness:
Overall Value:
Comments?
Age?
Under 18
19-34
35-54
55+
Male
Female
How did you learn about us?
Newspaper
TV
Radio
Friend
Other:
Restaurant Survey