Our goal is to make your dining experience unique, memorable and delicious.
So that we may better serve you, would you please take a moment to answer a few questions about your experience at Benihana.

Date
Chef	Server
Your visit with us today: Grill Sushi	Number in Party
How often do you visit Benihana?
What do you like most about us?
What do you like least about us?
Please rate us on the following:     Excellent Poor   a) Food Quality *required 5 4 3 2 1   b) Atmosphere *required 5 4 3 2 1   c) Chef Performance *required 5 4 3 2 1   d) Server Performance *required 5 4 3 2 1   e) Cleanliness *required 5 4 3 2 1   f) Entertainment *required 5 4 3 2 1   g) Overall Experience *required 5 4 3 2 1
Would you be interested in receiving information about our private meeting/party facilities?    Yes    No
Please fill out the following so we may keep you informed of special, upcoming events. In addition, we'll enter your name into a monthly drawing for a complimentary gift certificate!   Name: *required      Address:      City, State, Zip:      Email Address: *required      Home Phone:      Work Phone:      Birthday:      Spouse's Name/Birthday:      Anniversary:        Please check here if you are already on our mailing list.
Any additional comments or suggestions?
Thanks for visiting us... we look forward to seeing you again soon!