Palz Survey

Name:

Email:

Phone:

Please rate your experience with your host:

Poor

Average

Good

Exceptional

Did your server tell you their name?

Yes

No

Who was your server?

Did your server inform you of the specials for the day?

Yes

No

Please rate the quality of service you received from your server:

Poor

Average

Good

Exceptional

Was your server Courteous?

Yes

No

Was your server Informative?

Yes

No

Was your server Prompt & Efficient?

Yes

No

Please rate the quality of your meal:

Poor

Average

Good

Exceptional

Please rate your overall dining experience:

Poor

Average

Good

Exceptional

Additional Comments: