Buona

How often do you visit Buona?

Regularly
(More than once a Week on average)

Frequently
(Less than once a week on average)

Occasionally
(Once a month or less on average)

First Visit

Location of this visit:

Date:

Time:

Number in party:

Where did you come from?

Home

Work

Shopping

Other

Miles traveled?

Under 1

1-3

3-5

over 5

Items ordered:

List your favorite item(s) on the menu:

List any new item(s) on the menu you have tried recently:

Other item(s) you’d like added to the menu:

Rate our food, service, and value:

Please explain your rating of new items:

Do you think you’ll return to BUONA?

Yes No Not Sure

Would you recommend BUONA to friends?

Yes No Not Sure

Any other comments:

Full name:

Company:

Phone:

Address:

City, State, Zip:

E-mail address:

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