locations page

Your complete satisfaction is the goal of every member on our team. Let us know how we did. Please fill out the form below, your feedback is much appreciated.

Guest Check Dine Date
 
This number is located under the time on your
check and is very helpful in improving our services
to our guest.
Location:
Check here to stay informed on events,
offers and specials via e-mail
Contact Info:
First Name
Last Name
Address
City
State
Zip
Phone
Email
Address
Food & Beverage
What did you order ?
  Poor Fair Avg. Good Excellent
Taste
Freshness
Temperature
Timeliness
Portion
Value
Menu Variety
Would you order the item again ?
Comments
Staff
Waiter's name:  
  Poor Fair Avg. Good Excellent
Friendliness
Attentiveness
Knowledge
Comments
Restaurant
  Poor Fair Avg. Good Excellent
Cleanliness
Decor
Ambiance
How can we serve you better ?
Compared to other restaurants you dine at, rate
your overall experience
Will you return ?
How likely are you to recommend Lupe Tortilla to
friends, family, or colleagues ?
How likely are you to recommend Lupe Tortilla for:
    Very
Unlikely 		Unlikely Neutral Likely  Very
Likely
Singles/
Couples
Parents
Business Event
Social Event
Lunch
Dinner
Did your manager or chef visit your table ?
On average how many time a week do you dine
out ?
In the past month, how many times have you
visited us?

How did you hear about Lupe Tortilla ?
Additional Comments