Online Comment card
Here at HIP Restaurants we value your impressions; please assist us by evaluating your dining experience. Every month we will draw for a $100 Gift Certificate from all the participants. Good Luck! (**Required Fields)
**Your Name:
**Email:
**Confirm Email:
Address:
City:
Postal Code:
**Telephone:
Restaurant:
TEN Restaurant
**Date of Visit: (mm/dd/yy)
# of guests in your party:
Your Server's Name:
How did you hear from us?
Friends
Radio
Billboards
Newspaper
Internet
Bus Ads
Please Select
Was this your first visit?
Yes
No
What was the purpose of your visit?
Lunch
Dinner
Cocktails
Special Event
Other
Please Select
On a scale of 1 to 10 how would you rate the following categories with 1 being Needs improvement and 10 being Excellent
Food Quality:
10
9
8
7
6
5
4
3
2
1
Service:
10
9
8
7
6
5
4
3
2
1
Cleanliness:
10
9
8
7
6
5
4
3
2
1
Beverage Quality:
10
9
8
7
6
5
4
3
2
1
Atmosphere:
10
9
8
7
6
5
4
3
2
1
Did a manager visit your table?
Yes
No
Do you plan to join us again in the future?
Yes
No
If not, please share your reasons:
How could we have improved your experience?
Additional comments:
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