DATE OF VISIT*

    LOCATION*

    WHAT WAS YOUR DINING EXPERIENCE?*

    Dine-InPickupCatering

    NUMBER OF GUESTS IN PARTY*

    NAME OF RESTAURANT MANAGER

    NAME OF SERVER/BARTENDER

    WERE YOU GREETED IMMEDIATELY UPON ENTERING THE RESTAURANT?*

    YesNo

    WAS THE STAFF FRIENDLY & HELPFUL?*

    YesNo

    DID THE MANAGER VISIT YOUR TABLE?*

    YesNo

    HOW WAS THE QUALITY OF YOUR FOOD?*

    ExcellentGoodAverageFairPoor

    WAS YOUR ORDER ACCURATELY PREPARED?*

    YesNo

    HOW WAS THE OVERALL CLEANLINESS, ATMOSPHERE & STAFF APPEARANCE?*

    ExcellentGoodAverageFairPoor

    WILL YOU RETURN TO BUTERA'S?*

    yesno

    WILL YOU RECOMMEND BUTERA'S TO FAMILY & FRIENDS?*yesno

    HAVE ANY ADDITIONAL COMMENTS?

    FIRST NAME*

    LAST NAME*

    EMAIL*

    PHONE*