1. Name and location of establishment: ___________________________________
2. What was your first impression when entering the establishment?
3. How long were you in the establishment before someone acknowledged you?
4. How long before you were actually greeted? How were you greeted? Did he/she smile while saying it?
5. Did they introduce them self by name? (If so, what was it?)
6. Was the service provider courteous?
7. Do you think the service provider stereotyped you? If so, how?
8. Were they dressed appropriately for their job? (How were they dressed?)
9. What product/service were you seeking?
10. Make a special request (i.e. not something on the menu; not on the sales floor) and explain how they handled the request.
11. Act indecisive and explain how they handled you as the “indecisive customer”.
12. If a food establishment, did the server offer specials of the day? How long did it take to get your food after ordering? Do you think the time was reasonable? Was your order correct when you
13. Did the service provider adequately answer your questions or find out for you if they didn’t have the answer?
14. Did they check back with you to see if you needed further assistance?
15. Did you feel rushed by the service provider?
16. Did you have any problems while in the establishment? (If so, what) Explain how the situation was handled and did the service provider apologize for the error or inconvenience?
17. How well did the service provider perform their tasks? (Explain)
18. If a retail establishment, how long did you have to wait in line to pay for your purchase (if applicable)? Was it a reasonable amount of time? If it was too long, did the service provider acknowledge
your waiting time or apologize?
19. Did the service provider thank you for your purchase? Did they smile?
20. Did the service provider ask you to come back again?
21. Was the establishment clean, both inside and out (including floors, restrooms, sidewalk, parking lot, etc)? (Explain)
22. How would you rate your overall experience?
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