Have you visited our business in July?
Yes No
How would you rate your overall experience?
Excellent Good Average Poor
What service did you use during your visit?
Dining Shopping Entertainment Other
How likely are you to recommend us to a friend?
Very likely Likely Unsure Unlikely
What could we do to improve your experience?
Faster service Better product selection Enhanced customer service Other
Would you like to be contacted for follow-up regarding your feedback?
Yes No
All set, how can we reach you?
Name
Email
Phone
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