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Feedback

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   General
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Location Information

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Visit Information

1. Date of Visit Please enter a valid date in the format: M/D/YYYY *Required
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 Please enter a valid visit time(HH : MM : AM/PM) *Required
3. Visit Type Not Applicable Drive-thru Dine-in Catered Delivery Take out Curbside Pick-up *Required *Required
4. Order Method: Not Applicable At the Restaurant On mobile app Online via elpolloloco.com Online via DoorDash.com Online via Uber Eats Online via Postmates Online via Grubhub
5. Order Number:

Contact Details

1. First Name * *Required
2. Last Name * *Required
3. Country United States Country *Required
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4. State / Province / County Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State / Province / County *Required
5. Address *Required
6. City *Required
7. Zip Code Zip / Postal Code *Invalid *Required
8. Phone Phone *Invalid *Required
9. Email * *Invalid *Required
10. How May We Contact You? * Select One Email Phone No Contact Necessary *Required
11. Are you a member of our Loco Rewards Familia? *Yes
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Comments

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