Business Name *

Date and time of visit *

Name or brief description of who helped you *

Rate the attractiveness of the businesses outside appearance *

1 - poor 

3 - fair

5 -  great

Enter required value 1 2 3 4 5

Rate the outside cleanliness overall *

Clean sidewalks, windows, doors, etc.

1 - poor

3 - fair 

5 - great

Enter required value 1 2 3 4 5

Rate the accessibility of the establishment *

Parking, handicap, etc.

1 - poor

3 - fair 

5 - great

Enter required value 1 2 3 4 5

Rate the attractiveness of the businesses inside appearance *

1 - poor

3 - fair 

5 - great

Enter required value 1 2 3 4 5

Rate the cleanliness of the floors, tables, and bar *

1 - poor

3 - fair 

5 - great

Enter required value 1 2 3 4 5

Rate the atmosphere *

Do the tables feel crowded? Is their music too loud? Are you too close to the other guests?

1 - poor

3 - fair 

5 - great

Enter required value 1 2 3 4 5

Rate the overall appearance of the restaurant *

1 - poor

3 - fair 

5 - great

Enter required value 1 2 3 4 5

Please share any additional comments on the appearance, if any

Rate the welcome from the employees *

Were you promptly welcomed with a sincere greeting? 

1 - poor

3 - fair 

5 - great

Enter required value 1 2 3 4 5

Rate the general friendliness of the staff *

Were they warm and engaging? Did your server give you a prompt greeting and thank you?

1 - poor

3 - fair 

5 - great

Enter required value 1 2 3 4 5

Rate the attentiveness from your server *

Was the time from being sat to having the waiter/waitress come up prompt?

Did they consistently check in on you? 

Were the dishes cleared in a timely matter, was the bill presented and settled in a timely matter?

If not, please elaborate below.

1 - poor

3 - fair 

5 - great

Enter required value 1 2 3 4 5

Please share any comments on staff attentiveness here

Rate the servers knowledge on the menu and selections *

Did they try and upsell you on a certain dish, side dish, or beverage? 

Did they offer alternatives for special needs (e.g., gluten free, dairy free, etc.)

1 - poor

3 - fair 

5 - great

Enter required value 1 2 3 4 5

Rate the employees appearance *

Were they neat and appropriate?

1 - poor

3 - fair 

5 - great

Enter required value 1 2 3 4 5

Rate your conversation with your server? *

Did they thank you at the end of the conversation? Did they talk to you about what brought you in?

1 - poor 

3 - fair

5 -  great

1

2

3

4

5

Rate the overall experience with the staff *

1 - poor

3 - fair 

5 - great

Enter required value 1 2 3 4 5

Please share any additional comments on the staff, if any

Rate the overall impression of the menu selection *

1 - poor

3 - fair 

5 - great

Enter required value 1 2 3 4 5

Rate the menu *

Was it easy to read? Was it up to date and fresh?

Are the menu items at a good value for the given price point?

1 - poor

3 - fair 

5 - great

Enter required value 1 2 3 4 5

Rate the food *

Was it visually appealing? Was it at a good temperature when it came to the table?

1 - poor

3 - fair 

5 - great

Enter required value 1 2 3 4 5

Rate the overall range of food and beverages *

1 - poor

3 - fair 

5 - great

Enter required value 1 2 3 4 5

Please share any additional comments on the food/beverage, if any

Rate the wait time *

Were you waiting a long time from being sat to see your server? Did your food come out within a reasonable amount of time?

1 - poor 

3 - fair

5 -  great

1

2

3

4

5

Rate your overall experience *

Enter required value 1 2 3 4 5

Overall comments on your experience *

Please review the special asks (if applicable) and answer below

Special asks can be found in the initial email from baccintern@brookingschamber.org.

Please upload a copy of your receipt

Alternatively, you can email to info@brookingschamber.org or drop by our office at 1321 6th Street.

20MB max