The Old Church Restaurant Guest Satisfaction Survey

We value your confessions, tell us about your dining experience at The Old Church Restaurant

First name *
Last name *
Email address *
Phone number *
Address *
City *
Date of visit *
Was this your first visit to our restaurant? *	Yes No
How many guests were in your party? *
Who was your server? *
How did you hear about us? *
Please answer the following questions on a scale of 1 to 5. (1 is poor, 5 is outstanding)
Overall, how did you enjoy your dining experience? *	1 2 3 4 5
Comments
Please rate the food *	1 2 3 4 5
Comments
Please rate the wine list *	1 2 3 4 5
Comments
Please rate your server *	1 2 3 4 5
Comments
Please rate the rest of the service staff overall *	1 2 3 4 5
Comments
Any other comments?

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