When was your visit to The City Square Steakhouse?

Please rate your experience with the following:

Host Greeting
	Excellent	Good	Average	Below Average	Poor	NA
Atmosphere
	Excellent	Good	Average	Below Average	Poor	NA
Server / Other Staff
	Excellent	Good	Average	Below Average	Poor	NA
Food Quality
	Excellent	Good	Average	Below Average	Poor	NA
Drink Quality
	Excellent	Good	Average	Below Average	Poor	NA
Value for Money
	Excellent	Good	Average	Below Average	Poor	NA
Overall Experience
	Excellent	Good	Average	Below Average	Poor	NA

Please list the items you ordered:

Please list the items you would like to see on our menu:

Based on your experience, do you plan to return to The City Square Steakhouse?

Based on your experience, would you recommend The City Square Steakhouse to others?

Please feel free to add any additional comments.