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Guest Feedback Form
Share your experience by taking our quick survey and be entered into our monthly giveaway!
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1
What activities did you partake in today?
*
This field is required.
Wine Tasting
Bistro Dining
Private Event
Winery Tour
Picnic
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2
Employee Name
Memorable employees taking care of you today.
Employee Name #1
Employee Name #2
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3
How would you rate your experience today?
*
This field is required.
Wine Quality
Wine Selections
Staff Attentiveness
Food Selections
Food Quality
Speed of Service
Atmosphere
Wine Quality
Wine Selections
Staff Attentiveness
Food Selections
Food Quality
Speed of Service
Atmosphere
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4
How often do you dine with us?
*
This field is required.
Weekly
Monthly
Semi-Annually
Annually
First Time
Other
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5
What did you like best about your experience today?
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6
What did you like least about your experience today?
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7
How likely are you to recommend our establishment to your family & friends?
*
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1
2
3
4
5
Not Likely
Very Likely
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8
Other General Feedback:
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9
Please help us collect some general information about our guests:
*
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Gender
Male
Female
Male
Female
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10
Average Age Range of your group
*
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21-30
31-40
41-50
51-60
61+
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11
Where are you joining us from?
*
This field is required.
Stafford
Fredericksburg
Prince William
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12
Guest Name
First Name
Last Name
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13
How did you hear about Potomac Point Winery?
*
This field is required.
select all that apply.
Club Member
Returning Guest
Facebook
Friends/ Family
Online Search
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14
Guest E-mail
Required if you would like to be entered into the monthly drawing!
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15
Would you like to be added to our newsletter?
Find out about upcoming events, new wine releases, and more!
YES
NO
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