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customer feedback
Churchill's Customer Feedback Form
What was your dining experience?
Dine-In
Pickup
Catering
Date of your experience?:
Name of Server/Bartender:
How many guests were in your party?:
Please select...
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
17
18
19
20
21+
Were you greeted immediately upon entering the restaurant?
Yes
No
Was the staff friendly and helpful?
Yes
No
Did the manager visit your table?
Yes
No
How was the quality of food?
Excellent
Good
Average
Fair
Poor
Was your order accurately prepared?
Yes
No
How was the overall cleanliness, atmosphere and staff appearance?
Excellent
Good
Average
Fair
Poor
Will you return to Churchill's?
Yes
No
Will you recommend Churchill's to your friends and family?
Yes
No
Have any additional comments?
First Name
Last Name:
Email Address:
Captcha
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Weekly Kitchen Specials:
Monday - Sunday
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