Customer Feedback Form

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* 1. Name:

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* 2. At what email address would you like to be contacted?

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* 3. What is your age?

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* 5. What is your gender?

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* 6. Which Rockefeller location did you visit? 

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* 7. What time did you visit us? 

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* 8. Did the server greet you in the first 5 minutes?

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* 9. Was the server knowledgeable?

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* 10. Do you remember your servers name? (if not leave blank)

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* 11. How was the feel of the restaurant?

  Perfect Good Could Use Work Poor
Music
Lighting
Decor
Professionalism
Temperature
Cleanliness

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* 12. We'd love some feedback on the Menu...

  Perfect Good Needs Work Poor
Menu Offering
Dinner Choices
Happy Hour Choices
Brunch Choices

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* 13. Do you think we should put more traditional dinner entrees on our menu?

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* 14. Can you tell us what you ordered?

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* 15. Did the food come out correctly and on time?

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* 17. Any ideas that you'd like to see on the menu? Any changes? 

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* 20. Where else do you like to dine in the South Bay?

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* 21. What restaurants do you think we're similar to, or compete with us for your business in the South Bay?

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* 22. One idea to make us better would be ...

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* 23. If we wanted to tell you about a new menu item or a new promotion, what is the BEST way to reach you?

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* 24. General Comments. We'd love all your feedback!

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* 25. Would you recommend us to your friends? 

Thank you so much for the time you've taken -- we really appreciate it.  Looking forward to serving you soon. 
The Rockefeller

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