Stonebrooke Bar and Restaurant Survey

Please tell us about where you live Name:
Email:
City/Town:
State/Province:
ZIP/Postal Code:

	MM		DD		YYYY		HH		MM	AM/PM
Date and time of visit	When did you visit us? Date and time of visit Month	/	Day	/	Year		Hour	:	Minute	AM or PM

Were you greeted by a staff member in a timely manner? Yes

No

	Excellent	Good	Fair	Poor	N/A
Friendliness of Server	*Please rate the following on the service you received. Friendliness of Server Excellent	Friendliness of Server Good	Friendliness of Server Fair	Friendliness of Server Poor	Friendliness of Server N/A
Speed of Service	Speed of Service Excellent	Speed of Service Good	Speed of Service Fair	Speed of Service Poor	Speed of Service N/A
Appearance of your Server	Appearance of your Server Excellent	Appearance of your Server Good	Appearance of your Server Fair	Appearance of your Server Poor	Appearance of your Server N/A

Comments

	Excellent	Good	Fair	Poor	N/A
Quality of your entree	*Please rate the following. Quality of your entree Excellent	Quality of your entree Good	Quality of your entree Fair	Quality of your entree Poor	Quality of your entree N/A
Quality of your beverage	Quality of your beverage Excellent	Quality of your beverage Good	Quality of your beverage Fair	Quality of your beverage Poor	Quality of your beverage N/A
Portion Size	Portion Size Excellent	Portion Size Good	Portion Size Fair	Portion Size Poor	Portion Size N/A
Presentation	Presentation Excellent	Presentation Good	Presentation Fair	Presentation Poor	Presentation N/A
Quality of your dessert	Quality of your dessert Excellent	Quality of your dessert Good	Quality of your dessert Fair	Quality of your dessert Poor	Quality of your dessert N/A
Overall Dining Experience	Overall Dining Experience Excellent	Overall Dining Experience Good	Overall Dining Experience Fair	Overall Dining Experience Poor	Overall Dining Experience N/A
Cleanliness of Restaurant	Cleanliness of Restaurant Excellent	Cleanliness of Restaurant Good	Cleanliness of Restaurant Fair	Cleanliness of Restaurant Poor	Cleanliness of Restaurant N/A
Value	Value Excellent	Value Good	Value Fair	Value Poor	Value N/A

Comments

How frequently do you visit our restaurant? Over 6 times a month

3-5 times a month

1-2 times a month

Once every 2 months

Once every 3- 5 months

1-2 times a year

Do you plan to return to our restaurant? Yes

No

If No, why?

Are there any items you would like to see added to our menu?

Overall Suggestions/Comments:

Stonebrooke Bar and Restaurant