* 1. Name of establishment:

* 2. What was the location of establishment?

* 3. What was the date and time of your visit?

Date / Time
/
/
:

* 4. In the past 12 months, how many times have you visited our establishment?

* 5. Upon arrival were the parking lot, walkways and landscape clean and litter free?

* 6. Please rate your experience at the Host Stand with an answer of yes or no.

  Yes No Not Applicable
Was the Host(ess) well groomed and in a clean uniform?
Was the Host area clean and floors swept?
Did the Host(ess) suggest any specials or promotions to you?
Were you greeted by a Host(ess) within 30 seconds of your arrival?
Were you seated promptly and seated according to your quoted wait time

* 7. Please rate the SERVICE you received from your server or bartender with an answer of yes or no.

  Yes No Not Applicable
Was your server/bartender friendly and smiling?
Did your server/bartender suggestively sell an appetizer by name?
Was your server/bartender knowledgeable of our menu?
Did your server/bartender take the time to interact with you?
Were you informed of specials and promotions?
Were you offered monthly food or drink specials?
Would you return to our restaurant because of the service you received?
Did your server/bartender greet you with a bev nap within 2 minutes?
Did your server/bartender check back with you two minutes after food arrived?
Did your server/bartender anticipate your needs?
Was the employee well groomed and in a clean uniform?

* 8. Please rate the SERVICE you received during the food delivery process with an answer of yes or no.

  Yes No Not Applicable
Did your appetizer arrive before your entree?
Did your entree arrive in a reasonable amount of time?
Was your food presented by name when it was delivered?
Did the food runner ask if you needed condiments or anything else?
Was your order accurate?
Was your food prepared or cooked to your satisfaction?
Did your food look and taste fresh?
Did your server/bartender check back with you after food arrived?
Was your food runner well groomed, in a clean uniform?

* 9. Please rate the SERVICE you received during the food delivery process with an answer of yes or no.

  Yes No Not Applicable
Did your appetizer arrive before your entree?
Did your entree arrive in a reasonable amount of time?
Was your food presented by name when it was delivered?
Did the food runner ask if you needed condiments or anything else?
Was your order accurate?
Was your food prepared or cooked to your satisfaction?
Did your food look and taste fresh?
Did your server/bartender check back with you after food arrived?
Was your food runner well groomed, in a clean uniform?

* 10. Please rate the SERVICE you received during the beverage delivery process with an answer of yes or no.

  Yes No Not Applicable
Was your server/bartender knowledgeable about the beverages offered?
Was your beverage delivered within three minutes of placing the order?
Was your beverage served in the correct glassware?
Was your draught beer served with a 1" head?
Was your beverage served with the appropriate garnish?
Was your order accurate?
Were you given a fresh coaster with each beverage?
Were your beverages refilled promptly?
If at the bar was your tab placed in front of you?

* 11. Please rate the visibility of the Manager on Duty with an answer of yes or no.

  Yes No Not Applicable
Did you see a manager on duty?
Was the manager visible and interacting with guests?
Was the manager assisting employees where needed?
Were you able to easily identify who the manager was?
Was the manager well groomed and in a clean uniform?

* 12. Please rate the atmosphere with an answer of yes or no.

  Yes No Not Applicable
Was there an adequate selection of sporting events on the TV's?
Was the music selection or TV volume set at an acceptable level?
Was the temperature set an appropriate level?
Was the lighting appropriate for the time of day?
Were the restrooms clean?

* 13. Please rate your end of visit experience with an answer of yes or no.

  Yes No
Were your dishes and glassware cleared in a timely manner?
Was your guest check accurate?
Was your check cashed out within 4 minutes?
Did your server/bartender thank you and invite you to come back?

* 14. If you were a first time customer would you return based on your experience during this visit? (Please explain)

* 15. Please share your observations and any suggestions you may have for improving this establishment.

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