Your Feedback - This form is for the feedback of the restaurant ONLY. If you wish to contact the restaurant for other business please use contact form. All other information (not relevant to the feedback) will be ignored and deleted immediately.

At Pasquale's good customer service is priority and to ensure this we ask you to complete the form below. If needed, a member of management will contact you! Pasquale's does NOT sell or give away information that we collect. If you have any questions or concerns please see our privacy policy.

* Your Email

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(e.g. email@somewhere.com)

* Full Name

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Address

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City

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State

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Zip Code

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Phone Number

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* Location

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Derby, NY E. Aurora, NY West Seneca, NY

* How did you hear about us?

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Select News Paper Ad Outdoor Sign Previous guest Radio Ad Referral Telephone Directory T. V. Ad Walk In Web Site Other

Date of your dinner

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* Attitude of our personnel

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Excellent Good Fair Poor Rather not say

* Quality of service

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Excellent Good Fair Poor Rather not say

* Quality of food

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Excellent Good Fair Poor Rather not say NA

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Yes NO

* Will you return

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Yes No Rather not say

* Would you like a member of management to contact you?

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Yes No

Comments and suggestions

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Your message