Location Feedback Form
Please share your feedback about your recent experience at our location. Your input helps us improve our services.
Which location are you providing feedback for?
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Date of your visit
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 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Your full name
First Name
Last Name
Your email address (optional, for follow-up)
example@example.com
How did you hear about this location?
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Online search
Social media
Word of mouth
Advertisement
Other
Overall, how satisfied were you with your experience?
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1
2
3
4
5
Please rate the following aspects of the location:
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Rows
Excellent
Good
Average
Poor
N/A
Cleanliness
1
2
3
4
5
Staff friendliness
6
7
8
9
10
Facilities/amenities
11
12
13
14
15
Signage and directions
16
17
18
19
20
Accessibility
21
22
23
24
25
What did you like most about the location?
What could we improve?
Would you recommend this location to others?
*
Yes
No
Maybe
May we contact you for further feedback if needed?
Yes
No
Please verify you are not a robot
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