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*