1. What is your general satisfaction level with [RESTAURANT]?

Completely Satisfied

Satisfied

Normal

Dissatisfied

Completely Dissatisfied

2. Please mark your satisfaction level for the following attributes of our service:


Completely
Satisfied
Satisfied Neutral Dissatisfied
Completely
Dissatisfied
The dishes are served hot and fresh


The menu has a large variety


The quality of the food is excellent


The dishes are tasty and delicious


They brought the bill without errors


The wait staff was patient bringing
the bill


The food is served rapidly


Sauces, utensils, napkins, etc., were
readily available


The menu was easy to understand


The wait staff spoke clearly


The wait staff was kind and courteous


The price was correct


The outside of the restaurant was
clean


The interior of the restaurant was
clean



3. How often do you eat at [RESTAURANTE]?

Daily

Few times a week

Once a week

Few times a month

Once a month

Few times a year

At least once a year

Its the first time

Never

4. Based upon your experience would you visit [RESTAURANT] more regularly?

Yes

No

5. Would you recommend [RESTAURANT] to a friend?

Definitely

Probably

Probably Not

Definitely Not

Not Sure

6. When do you usually come to our restaurant?

Monday
to
Friday
Weekends

Lunch


Dinner


7. Sex:

Male

Female

8. Age:

9. How did you discover the restaurant?

TV

Newspaper

Radio

Movie

Internet

Other (please specify)