The Original Crusoe's Survey
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1.
Check Number
(Located on the top left corner of your receipt)

2.
Date of Your Visit to Crusoe's
Format: YYYY-MM-DD

3.
Server Name

4.
Arrived At
(time of arrival)

5.
Table Number
(Located on the top left of your receipt)

6.
Please rate the following
(1 = Poor 10 = Excellent)
  1 (Poor) 2 3 4 5 6 7 8 9 10 (Excellent)
How was your greeting when you entered the restaurant?
Were you satisfied with the time you waited to be greeted after being seated?
Was the staff poliet, professional, and enthusiastic?

7.
Would you like to have the same server on your next visit?

8.
How long have you been dining at our restaurant?

9.
How would you rate your overall level of satisfaction with us?

10.
Please rank the following attributes in order of importance when choosing a restaurant
(1 = Most Important 10 = Least Important)
  1 (Most Important) 2 3 4 5 6 7 8 9 10 (Least Important)
Reputation
Friendly Staff
Knowledgable Staff
Attentiveness of Staff
Cleanliness of Restaurant
Interior/Exterior Design
The Crowd (type of customer)
Quality of Food
Menu Selection
Menu Pricing and Value

11.
Please rate the following service items at our restaurant on a scale of 1 to 5
(1 = Poor 5 = Excellent)
  1 (Poor) 2 3 4 5 (Excellent)
Friendliness of Staff
Staff's Knowledge of the Menu
Attentiveness of Staff

12.
Please rate the following regarding ambiance at our restaurant on a scale of 1 to 5
(1 = Poor 5 = Excellent)
  1 (Poor) 2 3 4 5 (Excellent)
Cleanliness
Lighting
Music
Comfort

13.
Please rate the following regarding our menu on a scale of 1 to 5
(1 = Poor 5 = Excellent)
  1 (Poor) 2 3 4 5 (Excellent)
Quality of Food
Menu Variety
Menu Pricing and Value
Comfort

14.
Any comments regarding the service, ambiance, and/or menu at our restaurant

15.
How likely are you to recommend our restaurant to a friend or colleague?
Very Likely Likely Neutral Unlikely Very Unlikely

16.
How did you hear about our establishment?
Print Ad Internet Friends or Family Walk-In Other (please specify)

17.
Please share any suggestions for improving our restaurant.

18.
Would you like to be contacted by a member of our management team?
No If yes, please enter your name, address, email and phone number.

19.
Are you a member of our Lost Island Rewards Club?
Yes
No

20.
Would you like to receive communication regarding special promotions and offers?
No Yes! Please enter your name, addres, & email address.


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