Name:

Email:

Did you enjoy your experience? Yes No

Was your service up to your expectations? Yes No

Did you enjoy your meal? Yes No

Was our facility what you had hoped for? Yes No

Was this your first trip to The Publik House? Yes No

If yes, how did you find us?

Will you visit us again? Yes No

What part will you remember the most?

Who was your server or bartender today?

Other comments: