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Lang Restaurant Group Customer Survey
Thank you for dining with us. To help us maintain a high quality of service, please provide us with feedback by filling in the information below.
Date of Visit (MM/DD/YYYY)
*
Time of your visit
*
LUNCH (11AM-5PM )
DINNER (5PM-10PM)
LATE NIGHT (10PM-4AM)
Server Name (Their Name is on Your Receipt)
*
Was this your first visit to this restaurant?
*
Yes
No
Did a manager visit your table before your meal was complete?
*
Yes
No
What food items did you have?
What food items would like to see added to our menu?
What beers did you have?
What beers would you like to see us carry?
Comments or Suggestions
Please choose the best answer for each of the following.
*
Not Applicable
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
I was greeted politely
Not Applicable
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
The server was polite
Not Applicable
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
The server was always available
Not Applicable
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
The menu was easy to read
Not Applicable
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
I was satisfied with the selection of food
Not Applicable
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
My order was taken promptly
Not Applicable
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
My order was taken correctly
Not Applicable
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
My order was prepared and served promptly
Not Applicable
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
My order was prepared and served correctly
Not Applicable
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
The food tasted fresh
Not Applicable
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
The restaurant was clean
Not Applicable
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
The bathroom was clean
Not Applicable
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
My dishes and utensils were clean
Not Applicable
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Overall, how satisfied were you with your visit?
*
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
How likely are you to dine with us again?
*
Very Likely
Likely
Neutral
Unlikely
Very Unlikely
First Name
*
Last Name
*
Phone
*
Email Address
*
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