First Name
Last Name
Birthday		- month - January February March April May June July August September October November December - date - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 - year - 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Profession
Email
Work Phone
Date of your visit		- month - January February March April May June July August September October November December - date - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 - year - 2010 2011 2012
Meal		Lunch Dinner
How did you hear about us? - select - Word of Mouth OTOTO Facebook Other Facebook Dining Out 5280 Magazine Westword Denver Magazine Denver Life Magazine Search Engine - Google and Others Examiner Other website Hotel Recommendation Other How often do you dine at Izakaya Den? - select - First time Once a month Twice a month Three times a month Four times a month Five or more times a month 3 - 4 times a year Approximately how long did you wait to be seated? - select - Immediately 5 to 20 minutes 21 to 30 minutes 31 to 45 minutes 46 to 60 minutes Over 60 minutes If you had to wait, were you seated within the time quoted? Yes No Were you greeted promptly by a waitperson? Yes No Did your waitperson make suggestions on menu items? Yes No Did your waitperson possess enough menu knowledge? Yes No Did your waitperson possess enough wine or sake knowledge? Yes No Did your food arrive in a timely fashion? Yes No Did your waitperson check back with you? Yes No If you sat at the bar, did you receive good service from your sushi chef? Yes No NA Was your check presented to you in a timely fashion? Yes No Did you like your service? Yes No If you have already visited before, compared with last visit, is our overall service improving? Yes No NA Do you feel you received good value for what you paid? (If less value, please explain in the comment filed in the bottom of the questionnaire) More value Equal value Less value Would you recommend our restaurant to your friends and family? Yes No Please rate the following items: Excellent Good Adequate Poor N/A Rating Staff Name Manager Service Excellent Good Adequate Poor NA Chef Service Excellent Good Adequate Poor NA Waitperson Service Excellent Good Adequate Poor NA Host/Hostess Service Excellent Good Adequate Poor NA Bartender Service Excellent Good Adequate Poor NA Busser Service Excellent Good Adequate Poor NA Friendliness of Staff Excellent Good Adequate Poor NA Sushi - Freshness and Quality Excellent Good Adequate Poor NA Sushi - Flavor or Taste Excellent Good Adequate Poor NA Sushi - Presentation Excellent Good Adequate Poor NA Kitchen Food - Freshness and Quality Excellent Good Adequate Poor NA Kitchen Food - Flavor or Taste Excellent Good Adequate Poor NA Kitchen Food - Presentation Excellent Good Adequate Poor NA Wine Selection Excellent Good Adequate Poor NA Atmosphere Excellent Good Adequate Poor NA Cleanliness Excellent Good Adequate Poor NA Overall Rating Excellent Good Adequate Poor NA Any suggestions on how we can improve our restaurant or improve our Management? Comments are limited to 5000 characters*. *If you would like to give us more detailed feedback please email us at info@izakayaden.net close window