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Feedback Form
Please take a few moments out of your day to provide us with your thoughts about our operation. Your feedback will help us improve our service.

INSTRUCTIONS
Please check only one answer per question. On all question that have a 1-10 ranking consider the 10 to be GREAT, the 1 to be POOR and the 5 to be ADEQUATE.
 
1. What pizza did you order
  Example: 01/01/2010
 
2. What pizza did you order
  a. BBQ Chicken
  b. Veggie
  c. Pepperoni
  d. Other (Ham, Sausage, Bacon)
  e. Special Request
 
3. What did you think of the pizza
  1 2 3 4 5 6 7 8 9 10  
   
 
4. What is your favorite type of pizza
 
 
5. Rate our speed of service
  1 2 3 4 5 6 7 8 9 10  
   
 
6. How was our quality of service
  1 2 3 4 5 6 7 8 9 10  
   
 
7. Would you like to see our service...
  a. Once a Week
  b. Every Other Week
  c. Once a Month
  d. Don't Care
 
8. Would you have liked a small salad with your pizza
  a. Yes
  b. No
  d. Don't Care
 
9. Was a 10" pizza and a drink for $10 a good value
  1 2 3 4 5 6 7 8 9 10  
   
 
10. Please rate our overall service.
  1 2 3 4 5 6 7 8 9 10  
   
 
11. If you gave us a score of less than 5 then please tell us where we need improvement.
 
 
 
 
 
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