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Was your server courteous? *YesNo

Was your server informative? *YesNo

Was your server prompt and efficient? *YesNo

How frequently do you visit our restaurant? *1-2 times per month3-5 times per monthOnce every 2 monthsOther

Would you recommend our restaurant to a friend? *YesNo

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Reason

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?

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Signature

The Ultimate Loaf (Serves 7)

Description