MACON GUEST SATISFACTION SURVEY

As our guest, your opinion is valuable to us. Please take a few minutes to complete this survey and answer the following questions. We thank you in advance for completing this questionnaire.

Personal Information:

By participating in this survey, you will have the chance to win a gift card for your next visit. Every month we pick out a winner and we will be notifying you by email if you are the winner. Please fill out completely to be eligible for the prize drawing. Please be assured that La Parrilla is committed to protecting the privacy of our guests and we do not disclose any personal information that you provide, such as your name, e-mail address, or telephone number, to any outside parties.

First Name (Required)

Last Name (Required)

Email Address (Required)

Phone Number (Required)

000-000-0000 or (000) 000-0000

Guess Check Information

Please select the date and store location you visited. Enter your check number and server name which is located at the top of your check.

Date (Required)

Check Number (Required)

Server Name (Required)

1. Please rate each aspect of your experience from Poor to Excellent on the drop down below.

Service (Required)

Select an option

Attentiveness (Required)

Select an option

Cleanliness (Required)

Select an option

Taste of Food (Required)

Select an option

Order Accuracy (Required)

Select an option

Music/Ambience (Required)

Select an option

Overall Experience (Required)

Select an option

2. Please select your visit type (Required)

Dine in

Carry out

3. What time of the day was your most recent visit? (Required)

11:00am to 2:00pm

2:00pm to 5:00pm

5:00pm to 10:00pm

ADDITIONAL COMMENTS

I would like to receive future email offers from you (Required)

Yes

share-your-experience-macon

MACON GUEST SATISFACTION SURVEY

Personal Information:

Guess Check Information

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