Moot House Guest Feedback Question Title * 1. What was the date of your visit? Date Date Question Title * 2. How likely are you to recommend the Moot House? Extremely likely Very likely Somewhat likely Not so likely Not at all likely Question Title * 3. Which meal did you eat? Brunch Lunch Happy Hour Dinner Question Title * 4. Which menu items did you order today? Question Title * 5. Please rate the following: Very Poor Poor Okay Good Excellent Timeliness Timeliness Very Poor Timeliness Poor Timeliness Okay Timeliness Good Timeliness Excellent Taste Taste Very Poor Taste Poor Taste Okay Taste Good Taste Excellent Service Service Very Poor Service Poor Service Okay Service Good Service Excellent Overall Value Overall Value Very Poor Overall Value Poor Overall Value Okay Overall Value Good Overall Value Excellent Atmosphere Atmosphere Very Poor Atmosphere Poor Atmosphere Okay Atmosphere Good Atmosphere Excellent Cleanliness Cleanliness Very Poor Cleanliness Poor Cleanliness Okay Cleanliness Good Cleanliness Excellent Question Title * 6. Did a manager visit your table? Yes No Question Title * 7. Comments: Question Title * 8. Contact Info Name Address Address 2 City/Town State/Province ZIP/Postal Code Email Address Phone Number Question Title * 9. Would you like to receive our enewsletter? Yes No Done
