Please complete the form below. Mandatory fields marked *

Feedback Type

1. What type of feedback do you want to share? * Select One Restaurant Delivery Other

Restaurant Location

1. State / Province * Select One ACT NSW NT QLD SA TAS VIC WA
2. City * Select One
3. Address * Select One

Visit Information

1. Date of Visit
2. Time of Visit Time of Visit Hour 1 2 3 4 5 6 7 8 9 10 11 12 Time of Visit Minute 00 15 30 45 Time of Visit AM/PM AM PM
3. Visit Type Not Applicable Dine-in Drive Thru Take Away Delivery Pre-Order Pickup Mobile
4. Order Type: Not Applicable HJ APP HJ Website MenuLog Uber Eats Deliveroo Door Dash
5. Docket/Order Number:

Contact Details

1. First Name *
2. Last Name *
3. Country * Australia Country
   
4. State / Province / County * Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia State / Province / County
5. Address *
6. City *
7. Zip / Postal Code * Zip / Postal Code
8. Phone * Phone
9. Email *
10. How May We Contact You? * Select One Email Phone Mail No Contact Necessary

Comments

1. Please enter your comments and feedback below: *
   

Attachments

1. Please attach any relevant files:
   Add Attachment Attachment1