Guest Feedback Form To better serve you, we welcome your feedback and comments!! Date Visited: Time Visited: Server / Bartender: Our meal was: AverageGoodOutstanding Our service was: AverageGoodOutstanding Your comments and suggestions about our restaurant / staff are greatly appreciated: How did you hear about us? ( if not listed below, please include in comments area below ) Web / Social MediaPrintWord of MouthOther Your Name (required) Your Email (required) Your contact phone number xxx-xxx-xxxx ( not required ) Your Birthday Month ( not required ) Please contact me regarding our visit? YesNo May we save your email address for future emails concerning special events or pricing? Your email will ONLY be used for this purpose. NO SPAM YesNo .