The Signature Room at the 95th®
875 N. Michigan Ave.
Chicago, IL 60611
Phone: 312.787.9596
E-Mail

The Signature Room at the 95th®

Dining Experience Evaluation

Did you dine with us	Lunch Dinner Sunday Brunch
First Name:		Last Name:

Address:		Suite / Apt. No.:

City:
State:		State Other:

Country:		Zipcode:	(ZIP Code)
Phone Number:	(Phone Number)
Email:	(E-mail)
Date of Visit:	(Date mm/dd/yyyy)

Area of Service		Score
Quality of Interaction with Staff:
	Satisfaction with reservationists:	poor 1 2 3 4 5 excellent
	Satisfaction with host/hostess:	poor 1 2 3 4 5 excellent
	Satisfaction with wait staff:	poor 1 2 3 4 5 excellent

Quality of Food:
	Food Presentation:	poor 1 2 3 4 5 excellent
	All courses served at appropriate temperature:	poor 1 2 3 4 5 excellent

Quality of Service:
	Courses properly timed:	poor 1 2 3 4 5 excellent
	Professionalism of wait staff:	poor 1 2 3 4 5 excellent

Quality of Event Space:
	Cleanliness of dining room:	poor 1 2 3 4 5 excellent
	Cleanliness of restroom:	poor 1 2 3 4 5 excellent
	Satisfaction with ambiance of the restaurant:	poor 1 2 3 4 5 excellent

Overall Satisfaction with Experience:
		poor 1 2 3 4 5 excellent
What aspect of your experience did you enjoy the most?

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THANK YOU FOR CHOOSING THE SIGNATURE ROOM AT THE 95TH ®! WE LOOK FORWARD TO SERVING YOU IN THE FUTURE!

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