Clearmans 2023 Receipt survey

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1. What location of ours did you visit? (Required.)

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2. Email - required for entry into the $75 monthly Gift Card drawing (Required.)

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3. Phone Number - required for entry into the $75 monthly Gift Card drawing (Required.)

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4. Receipt Number - required for entry into the $75 monthly Gift Card drawing (Required.)

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5. What date did you visit us?

Date

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6. What time of day did you visit us?

Time

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7. Was this your first time dining here?

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8. My food order was accurate

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9. Did your food arrive in a timely manner?

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10. Did the quality of food meet your expectations?

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11. The Staff and Service were excellent

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12. Are you happy with our variety of beer selections?

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13. If you ordered a cocktail, was it made to your liking?

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14. The food is good value for the money spent

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15. What entree would you like to see added to the menu?

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16. What is your age?

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17. What zipcode is your home located? (enter 5-digit ZIP code; for example, 00544 or 93405)

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