Cluck-U Chicken Survey Form

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Cluck-U Chicken: It's an Addiction!!!

Cluck-U Chicken Survey Form

Fresh Food Grilled or Fried U Decide *

Customer Survey


Date of Visit: //mm/dd/yyyy	Time: :
Store Location:
Email address:
How would you rate us?	Excellent	Very Good	Good	Fair	Poor
1. FOOD QUALITY	5	4	3	2	1
2. PRICE/VALUE	5	4	3	2	1
3. EMPLOYEE COURTESY	5	4	3	2	1
4. SPEED OF SERVICE	5	4	3	2	1
5. ORDER ACCURACY	5	4	3	2	1
6. CLEANLINESS (FLOORS, TABLES, RESTROOMS)	5	4	3	2	1
7. COMFORT AND ATMOSPHERE	5	4	3	2	1
8. YOUR OVERALL EXPERIENCE ON THIS OCCASION	5	4	3	2	1
INCLUDING THIS VISIT, HOW MANY TIMES DID YOU VISIT CLUCK-U CHICKEN WITHIN THE PAST MONTH?	5+	4	3	2	1
BASED ON THIS VISIT WOULD YOU ORDER FROM US AGAIN?	Yes No Maybe
HOW DID YOU HEAR ABOUT US?
HOW CAN WE BECOME BETTER?

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