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

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* 2. Date of Visit and server name:

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* 3. Age and Gender:

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* 4. What brought you into the restaurant today?

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* 5. How was your service?

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* 6. How clean was our restaurant?

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* 7. Was the food to your standards?

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

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

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

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