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Time spent
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Question 1*
What is your Name
Question 2*
What is your member number
Question 3*
Rate your service between 1 and 5 1 being poor and 5 being excellent
1 (poor)
2 (not so good)
3 (ok)
4 (very good)
5 (excellent)
Joe Smith
1 (poor)
2 (not so good)
3 (ok)
4 (very good)
5 (excellent)
Sandy Kol
1 (poor)
2 (not so good)
3 (ok)
4 (very good)
5 (excellent)
Question 4*
Please rate food quality
Excellent
Very Good
Neutral
Bad
Terrible
Food Quality
Excellent
Very Good
Neutral
Bad
Terrible
Question 5*
Please rate your service quality
Excellent
Very Good
Neutral
Bad
Terrible
Service Quality
Excellent
Very Good
Neutral
Bad
Terrible
Question 6*
Please rate cleanliness
Excellent
Very Good
Neutral
Bad
Terrible
Service Quality
Excellent
Very Good
Neutral
Bad
Terrible
Question 7*
Please rate overall expereince
Excellent
Very Good
Neutral
Bad
Terrible
Service Quality
Excellent
Very Good
Neutral
Bad
Terrible
Question 8*
Other Comments You would like to make
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