Restaurant Evaluation Form
Water quality is very important in a restaurant because it makes up more than 90% of hot and cold non-alcoholic beverages and in the ice that is in alcoholic beverages. PureOFlow offers you an opportunity to evaluate the water quality at restaurants at which you dine. Submit your evaluation of whether or not they have a water purification system and enter to win a $50 gift certificate. All information must be completed for award eligibility. Multiple submissions are welcome.
Name
E-mail
Your Phone:
Restaurant Name
Restaurant Address:
Restaurant Zip:
Restaurant State:
Restaurant City:
Restaurant Phone:
Beverages ordered?



Overall, how satisfied are you with beverage taste?





Does the Restaurant have a water purification system?


If yes, what is the type/name?



Are they part of the Pure Water Revolution?