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Customer Survey
Requested Information
Date:
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Time of Visit
Servers Name:
Why did you choose MR. CHINESE, and how did you hear about us?
Do you visit ofter?
- Choose an Option -
Once a week
Once to twice a month
Less than once a month
My first visit
How do you rate the service; was it friendly and efficient?
- Choose an Option -
Poor
Fair
Good
Excellent
Comments:
How would you rate the food quality?
- Choose an Option -
Poor
Fair
Good
Excellent
Comments:
What would you improve on if you owned this restaurant?
Name:
Birthday:
January
February
March
April
May
June
July
August
September
October
November
December
01
02
03
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05
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Address:
Postal Code:
Telephone No: