Date of visit:

Time of visit:

A.M. P.M.

Name:

Phone:


Email:

How often do you come to Bountiful Bread?

Daily Weekly
Monthly Occasionally

What did you order/purchase?

Were you taken care of by the counter staff in a timely manner?

Yes No

What item(s) did you like best?

How would you rate the quality of our products?:

How would you rate our customer service?:

Overall, how would you rate your visit?

Would you come back?

Yes No

Other comments or suggestions: