The yellow house feedback form
General feedback
Specific feedback

How did you first hear about us? (please select below)
Passing by
Leaflet handed out at the Tube station
Postcard mailing
Advertisements in local paper
Metro 'review'
Recommended
Other - please specify:

For specific feedback - date & time of visit.

How often do you visit us? (please select closest 'match')
First visit
Daily
More than once per week
Once per week
Once per two weeks
Once per month
Once per quarter
Once per half year
Once per year

Please select your score: poor


excellent

1
 2
 3
 4
 5
Reception & friendliness
Variety of dishes offered
Quality of the food served
Selection of wines offered
Selection of other drinks offered
Standard of table service offered
Value for money
Atmosphere
Cleanliness


Comments & suggestions: (optional)


Favourite main course:
Favourite pizza:
Favourite pudding:
Favourite wine:
Favourite wine grape (e.g. Shiraz):


Would you recommend us to someone else?

 Yes No Don't know


If you would like us to respond to your comments, please provide your contact details: (optional)
Name:
e-mail:
Telephone:
Address:
Post code: