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Your Name:
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Date of Service:
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Please take a moment to rate the following:

Excellent=5  Very Good=4   Good=3   Fair=2   Poor=1
Rate our Food: 1     2     3     4     5    
Rate our Service: 1     2     3     4     5    
Rate the Cleanliness: 1     2     3     4     5    
Rate the Atmosphere: 1     2     3     4     5    
Would you recommend Carbone's to others?



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