JACKSONS QUESTIONNAIRE

How are we doing?

We are committed to providing you with the best dining experience possible, so we welcome your comments. Please fill out the form below so that we can improve our services!

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Please rate the quality of the service you received from your host.
( 1 = Great | 5 = Poor )

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Please rate the quality of the service you received from your server.
( 1 = Great | 5 = Poor )

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Was your server…

Courteous?
YesNo

Informative?
YesNo

Prompt and effecient?
YesNo

Please rate the quality of your entree.
( 1 = Great | 5 = Poor )

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Please rate the quality of your beverage.
( 1 = Great | 5 = Poor )

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Please rate your overall dining experience.
( 1 = Great | 5 = Poor )

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How frequently do you visit our restaurant?

3-5 times/month1-2 times/month

Once every 2 monthsOther

Do you plan to return to our restaurant?

YesNo

Would you recommend our restaurant to a friend?

YesNo

Why would you recommend it, or why not?

If your visit was to celebrate a special occasion, how might we have made it more memorable?

What dish did you order?

What dishes would you like added to our menu?

Please share any additional comments or suggestions.

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