A. Name (optional): If you desire followup, please enter your NAME.
B. Mailing Address (optional): If you desire followup, please enter your STREET address or P.O. BOX number.
C. City (required): Please enter the name of the CITY where you reside.
D. State (required): Please enter the name of the STATE (or foreign country) where you reside.
E. Zip Code (required): Please enter the ZIP CODE where you reside.
F. Telephone (optional): If you desire followup, please enter the best TELEPHONE number to reach you.
G. E-mail (optional):
H. Date & Time: Please indicate the DATE and approximate TIME of the dining experience being evaluated on this survey.
1. Seating: Extremely Satisfied Very Satisfied Satisfied Unsatisfied Very Unsatisfied Extremely Unsatisfied Please rate your satisfaction pertaining to the manner and efficiency in which you were SEATED.
2. Table: Extremely Satisfied Very Satisfied Satisfied Unsatisfied Very Unsatisfied Extremely Unsatisfied Please rate your satisfaction pertaining to the location of the TABLE and the condition of the SURROUNDINGS where you were seated.
3. Service: Extremely Satisfied Very Satisfied Satisfied Unsatisfied Very Unsatisfied Extremely Unsatisfied Please rate your overall satisfaction pertaining to the level of SERVICE you received, including the politeness and competence of the server.
4. Preparation Time: Extremely Satisfied Very Satisfied Satisfied Unsatisfied Very Unsatisfied Extremely Unsatisfied Please rate your overall satisfaction with the length of time required to PREPARE your food.
5. Food: Extremely Satisfied Very Satisfied Satisfied Unsatisfied Very Unsatisfied Extremely Unsatisfied Please rate your overall satisfaction pertaining to the quality of the FOOD you were served, including flavor, temperature, portion & presentation.
6. Beverage: Extremely Satisfied Very Satisfied Satisfied Unsatisfied Very Unsatisfied Extremely Unsatisfied Please rate your overall satisfaction pertaining to the quality of the BEVERAGE(S) you were served, including flavor, temperature, portion & presentation.
7. Cleanliness: Extremely Satisfied Very Satisfied Satisfied Unsatisfied Very Unsatisfied Extremely Unsatisfied Please rate your overall satisfaction pertaining to the CLEANLINESS of the restaurant including the condition of the restroom, if used.
8. Value: Extremely Satisfied Very Satisfied Satisfied Unsatisfied Very Unsatisfied Extremely Unsatisfied Please rate your overall satisfaction pertaining to the VALUE you received compared to the price you paid for your dining experience.
9. Comparison: Extremely Favorable Very Favorable Favorable Similar Unfavorable Very Unfavorable Please indicate how your overall dining experience COMPARED to dining experiences you customarily have at other fine dining establishments.
10. Recommendation: Absolutely Extremely Likely Likely Undecided Not Likely Extremely Unlikely Please indicate how likely you are to RECOMMEND The Orangery to someone you know.
I. Comments: Please use this space to provide additional COMMENTS or specific DETAILS pertaining to the quality of your dining experience.
J. Followup: No thank you. That won’t be necessary. Yes, please call me at the number I have provided. Yes, please send me an e-mail at the address I have provided. Yes, please send me a letter at the address I have provided. Please indicate if you wish to receive FOLLOWUP pertaining to any of the comments you have included on this survey.
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