Name:
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Email Address:
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Address:
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Address:
Phone Number:
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Date and Time of Your Visit:
Location of Your Visit:
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Quail Corners
Providence / Ballantyne
Cotswold
Myers Park
(required)
How was the quality of your food? Unsatisfactory 1‐5 Excellent
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5
4
3
2
1
How was the quality of the service? Unsatisfactory 1‐5 Excellent
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5
4
3
2
1
How was the quality of the atmosphere? Unsatisfactory 1‐5 Excellent
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5
4
3
2
1
What was the quality of the cleanliness? Unsatisfactory 1‐5 Excellent
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5
4
3
2
1
How was the quality of value? Unsatisfactory 1‐5 Excellent
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5
4
3
2
1
Was this your first visit to WP?
Yes
No
How likely is it that you will return in the next 3‐6 months?
Very Likely
Unlikely
We would like to recognize our staff members for excellence. Were
you “wowed” to day by any staff member?
Yes
No
Suggestions or Comments:
Thank you for your comments!