Menu
Locations
Guest Rewards Program
About
Franchise Info
Crossword Through Time
Feedback
If you are a human and are seeing this field, please leave it blank.
Fields marked with an
*
are required
Name
*
Street Address
City/Town
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
North West Territories
Nova Scotia
Nunavut
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code
Phone
*
Email
*
Age
*
18 & Under
19 - 30
31 - 40
41 - 55
56+
Occupation
Restaurant
Restaurant
*
AB - Calgary - 6510-4th Street NE
AB - Calgary - 2505 Macleod Trail South
AB - Calgary - 164
AB - Calgary - #530 - 5255 Richmond Road SW
AB - Calgary - #102
AB - Calgary - 14315 Macleod Trail South
AB - Calgary - 1619-46 Street NW
AB - Calgary - #234
AB - Calgary - #250
AB - Calgary - 7007-11 Street SE
AB - Calgary - Trans Canada Center
AB - Calgary - 42148 Highway #1 (Hwy #1 & #22 Junction)
AB - Camrose - 5606-48 Avenue
AB - Cold Lake - 4207-50 Street
AB - Crossfield - Highway #2 North (Box 1129)
AB - Edmonton - 12503-127 Street
AB - Edmonton - 4503 Gateway Blvd
AB - Edmonton - 9910-108 A Avenue
AB - Edmonton - 9555-82 Avenue
AB - Edmonton - 5011-130 Avenue
AB - Edmonton - 13232-97 Street
AB - Edmonton - 17006-90 Avenue
AB - Fort Saskatchewan - 8815-101 Street
AB - Grande Prairie - 13211-100 Street
AB - Lethbridge - 205 Scenic Drive South
AB - Medicine Hat - 1343 Trans Canada Way SE
AB - Nanton - 2810 - 21 Avenue North (Box 1770)
AB - Red Deer - 100
AB - Red Deer - #112
AB - Red Deer - 153 Leva Avenue
AB - Spruce Grove - #20
AB - Strathmore - 503 Alberta Highway 1
AB - Sylvan Lake - #3 Hwy 11 A (Sylvan Corner Centre)
AB - Whitecourt - 5123 Keplar Street W
BC - Fort St. John - 11724 Alaska Road (Box 6809)
MB - Brandon - 100 Highland Avenue
MB - Brandon - 1525-18 Street
MB - Oak Bluff - #2
SK - Estevan - 421 Kensington Avenue
SK - Kindersley - 105-11 Avenue West (Box 2288)
SK - Lloydminster - 4903-44 Street
SK - Moose Jaw - 1702 Main Street North
SK - North Battleford - Hwy #16 Bypass (Box 1208)
SK - Prince Albert - 1201-2 Avenue West
SK - Regina - 1616 Albert Street
SK - Saskatoon - 405 Circle Drive East
SK - Swift Current - Rural Delivery Hwys #1 & #4
Date & Time Visited
*
How did you hear about us?
*
Newspaper
Radio Station
TV
Driving By
Word of Mouth
Other
Number of people in your party
How long?
Did you have to wait for a table?
*
Yes
No
Was the restaurant clean?
*
Yes
No
Was your table clean?
Yes
No
What are was not clean?
Server's Name
Did you have?
*
Breakfast
Lunch
Dinner
Please Rate Our Food On
Taste
*
Excellent
Very Good
Fair
Poor
Temperature
*
Excellent
Very Good
Fair
Poor
Portion Size
*
Excellent
Very Good
Fair
Poor
Price
*
Excellent
Very Good
Fair
Poor
Please Rate Your Service Today
Promptness
*
Excellent
Very Good
Fair
Poor
Friendliness
*
Excellent
Very Good
Fair
Poor
Attentiveness
*
Excellent
Very Good
Fair
Poor
Accuracy
*
Excellent
Very Good
Fair
Poor
Additional Information
How would you rate this restaurant?
*
Excellent
Very Good
Fair
Poor
How often do you visit Humpty's Family Restaurants?
*
1st Time
Weekly
Monthly
Once or twice a year
Other Comments and Suggestions
