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*