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Salt & Ember Survey Card
Name
Service
Friendliness
*
5 Excellent
4
3
2
1 Unsatisfactory
Timeliness
*
5 Excellent
4
3
2
1 Unsatisfactory
Knowledgeability
*
5 Excellent
4
3
2
1 Unsatisfactory
FOOD
Quality
*
5 Excellent
4
3
2
1 Unsatisfactory
Appearance
*
5 Excellent
4
3
2
1 Unsatisfactory
Taste
*
5 Excellent
4
3
2
1 Unsatisfactory
Value
*
5 Excellent
4
3
2
1 Unsatisfactory
Atmosphere
Cleanliness
*
5 Excellent
4
3
2
1 Unsatisfactory
Comfort
*
5 Excellent
4
3
2
1 Unsatisfactory
Ambience
*
5 Excellent
4
3
2
1 Unsatisfactory
Overall Experience
*
5 Excellent
4
3
2
1 Unsatisfactory
What entrée did you order?
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How satisfied are you with your overall experience?
Please share your thoughts on what we can do to improve your dining experience.
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AL
AR
AZ
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CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
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