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Restaurant Location:	Time:	Date:
Your comment will help us serve you better. We thank you for taking the time to give us suggestions. About our food
What is your favorite?	What did you order today?	Temperature of the food Excellent Good Regular Bad
Taste Excellent Good Regular Bad
About the quality of our service
Hostess services Excellent Good Regular Bad	Waiter service Excellent Good Regular Bad	Waiter appearance Excellent Good Regular Bad
Waiter speed Excellent Good Regular Bad	Was your table assigned quickly? Yes No	How long did it take you to get the table? 1 5 10 15 + min
Did the waiter introduce himself? Yes No	If yes waiter's name:
About Our Restaurant
Atmosphere Excellent Good Regular Bad	Music Excellent Good Regular Bad	Cleanliness Excellent Good Regular Bad
Restroom cleanliness Excellent Good Regular Bad	Is this the first time you visit us? Yes No	How many times per month do you visit us? 1 2 3 4 5 + times
Were your questions regarding our products and services answered to your entire satisfaction? Yes No
What facility or service that you found in this location would you like to find at other Sardi's chicken locations?
What would you recommend us to better serve you?
Contact Information
Name: *	Address:	Phone:
Birthday:	Business:	Email Address: *