Q1: Name

Q2: Email Address

Q3: How do you rate Blah Blah Blah restaurant? (1 - Low, 10 - High)

1 (Low) 2 3 4 5 6 7 8 9 10 (High)

Q4: Why did you give it this rating?

Q5: How do you rate the Blah Blah Blah restaurant website? (1 - Low, 10 - High)

1 (Low) 2 3 4 5 6 7 8 9 10 (High)

Q6: Why did you give it this rating, and how could it be improved?

Q7: Any other comments?

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