* 1. Your name, email, and phone number:

* 2. Date of Visit and server name:

* 3. Age and Gender:

* 4. What brought you into the restaurant today?

* 5. How was your service?

* 6. How clean was our restaurant?

* 7. Was the food to your standards?

* 8. What was the atmosphere of the restaurant like?

* 9. How would you improve the restaurant to make it better?

* 10. What did we do that you really enjoyed?

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