Customer Feedback Form
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Taste
*
1
2
3
4
5
5 Means Loved it, 1 means Worst
Service
*
1
2
3
4
5
5 Means Loved it, 1 means Worst
Ambience
*
1
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4
5
5 Means Loved it, 1 means Worst
Quality
*
1
2
3
4
5
5 Means Loved it, 1 means Worst
Portion size
*
1
2
3
4
5
5 Means Loved it, 1 means Worst
Value for Money
*
1
2
3
4
5
5 Means Loved it, 1 means Worst
Would your Recommend our restaurant to Others?
*
1
2
3
4
5
5 Means Loved it, 1 means Worst
Suggestions / Comments
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