Date of Visit: *              Time: *        Please Choose morning midday evening

Was This Your First Visit?

Yes  No

Type Of Visit:

Dine-In   Take-Out   Delivery

 

What Did You Purchase?

Breakfast	Coffee	Sandwich	Soup
Beverage	Espresso	Pita	Salad
Dessert	Side Dish	Kid's Meal	Other
Beer	Wine

 

Rate Your Visit:

		Excellent	Good	Fair	Poor
Inside Appearance Floor, tables, chairs, windows, countertops.
Cafe Atmosphere Comfortable temperature, music volume or genre, etc.
Staff Well groomed, friendly, polite and helpful.
Speed of Service Order taken promptly and received in a timely manner?
Order Accuracy All items received and made correctly?
Food Quality Please rate the overall quality of the food.
Value Do you feel you received a good value for the money?
Overall Experience How do you feel about your  dining experience?

Additional Comments:

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