We Value Your Opinion

Date: Time:

Item(s) Ordered:

Number of guests in party:

	Great	Good	Not So Great
How was our Food?
Quality
Freshness
Temperature
Flavor
How was our Service?
Efficient
Friendly
Helpful
Ambience
Cleanliness
Decor
Music
Value
Pricing
Portion Size

Comments/Menu Suggestions:

Visit Our Website:

www.TheOriginalSteves.com

What brought you in:

Newspaper Ad	Yellow Pages	Direct Mail
Flier	Coupon	Website
Facebook	Friend, Co-Worker, Family	Others
If others pls specify:

How often do you eat at Original Steve's?:

What would bring you back more often?:	Our Pizzas	Our Pasta
	Our Salads	Our Sandwiches

What menu items would you like to see improved or added:

What beverage items would you like to see improved or added:

Testimonial:

Please fill out the following information to be included in our mailing list. We send out coupons, special offers, and more to members of our mailing list. Who knows you might be entered to win a free prize or something! Just check back with us.

*Name:	A value is required.
*Address:	A value is required.
*Email:	A value is required.
*Phone #:	A value is required.

*Enter code: A value is required.