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Service Survey
* = Required Field
Name*
:
Email*
:
Phone*
:
Address*
:
Which Ziggie's Location did You Visit?*
:
Springfield: 4228 S. National
Springfield: 2222 S. Campbell
Springfield: 935 N. Glenstone
Springfield: 1324 W. Kearney
Carthage: 1926 S. Garrison
Nixa: 911 N Kenneth
Republic: 1230 US HWY 60
Rolla: 1049 Kingshighway St
West Plains: 1613 Porter Wagoner Blvd.
Server Name*
:
Date of your visit*
:
1
2
3
4
5
6
7
8
9
10
11
12
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Is this your first visit?*
:
yes
no
How did you hear about us?*
:
Friend
Newspaper
Walk-in
Website
Magazine
Other
Overall Experience*
:
Excellent
Good
Average
Fair
Poor
Greeting by Hostess*
:
Excellent
Good
Average
Fair
Poor
Manager (Table Visit)*
:
Excellent
Good
Average
Fair
Poor
Overall Service*
:
Excellent
Good
Average
Fair
Poor
Professionalism*
:
Excellent
Good
Average
Fair
Poor
Menu Knowledge*
:
Excellent
Good
Average
Fair
Poor
Friendliness*
:
Excellent
Good
Average
Fair
Poor
Menu Selection*
:
Excellent
Good
Average
Fair
Poor
Food Quality*
:
Excellent
Good
Average
Fair
Poor
Food Presentation*
:
Excellent
Good
Average
Fair
Poor
Value for $ Spent*
:
Excellent
Good
Average
Fair
Poor
Cleanliness of Restaurant*
:
Excellent
Good
Average
Fair
Poor
Cleanliness of Restroom*
:
Excellent
Good
Average
Fair
Poor
Cleanliness of Exterior*
:
Excellent
Good
Average
Fair
Poor
What comments would you give us to improve our restaurant?*
:
* = Required Field
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