SAMPLE PATRON SURVEY
[Casino Name Here]
How was your visit to [Casino Name Here]?
Your feedback is greatly appreciated and your comments allow us to better serve you. Please fill out this survey and return it in the postage paid envelope and you can receive $10 in free play on your [Players’ Club Name] card. Thank you for your contribution in making [Casino Name Here] a better place!
Q1. What do you like best about [Casino Name Here]? (Please check only one answer.)
__ Gaming Experience
__ Food
__ Service
__ Location
__ Favorite Game
__ Other (please specify)
Q2. When you visit [Casino Name Here], do you usually spend money on any of the following items?
a. Food and beverage
__ Yes
__ No
__ Don’t know
b. Hotel or lodging
__ Yes
__ No
__ Don’t know
c. Retail purchase
__ Yes
__ No
__ Don’t know
d. Entertainment (shows, dancing, concerts, etc.)
__ Yes
__ No
__ Don’t know
e. Gambling
__ Yes
__ No
__ Don’t know
Q3. In the past 12 months, have you reduced the number of trips to [Casino Name Here] due to any of the following? (Please check all that apply.)
__ I have not reduced the number of trips to a casino
__ Cost of gasoline
__ Loss of income
__ Decline in health
__ Falling behind on your bills
__ Loss of job
__ Declining value of your home
__ Increased cost of living
__ Other (Please describe)_______________________
Q4. All things being equal in terms of size, gaming options, and distance from your home, would you be more likely or less likely to visit [Casino Name Here] if smoking were prohibited on the gaming floor, or does it matter?
__ Much more likely
__ More likely
__ Less likely
__ Much less likely
__ Does not matter
Q5. Does smoke in the casino bother you?
__ Very much
__ Somewhat
__ Not much
__ Not at all
Q6. Do you believe that breathing secondhand smoke can be harmful to health?
__ Very much
__ Somewhat
__ Not much
__ Not at all
Q7. What games do you play when you gamble at [Casino Name Here]? (Please check all that apply.)
__ Slots (video slots, video, keno, video poker, video blackjack, etc.)
__ Table games, not including the poker room
__ Poker in the poker room
__ Keno (SuperSlots)
__ Bingo
__ Other (Please describe)_______________________
Q8. What one game do you play most often, or do you play them all equally? (Please check only one answer.)
__ Slots (video slots, video, keno, video poker, video blackjack, etc.)
__ Table games, not including the poker room
__ Poker in the poker room
__ Keno (SuperSlots)
__ Bingo
__ Other (please describe)_______________________
__ Play them equally
Q9. Do you smoke commercial tobacco (cigarettes, cigars, cigarillos, etc.)?
__ Yes
__ No
Q10. Do you ever smoke while you play?
__ Yes
__ No
Q11. Which of the following categories describe your racial or ethnic identity? (Please check all that apply.)
__ American Indian/Alaska Native/Native
__ White/Caucasian
__ African American
__ Hispanic or Latino
__ Asian
__ Other (Please describe) ___________________________
Q12. Without telling us your exact income, into which category did your total household income for the past year fall?
__ Less than $20,000
__ $20,000–$39,999
__ $40,000–$79,999
__ $80,000–$119,999
__ $120,000 or more
Q13. Which of the following categories describes your current level of education?
__ Less than high school
__ High school graduate or equivalent (GED/HSED)
__ Some college
__ College graduate
__ Graduate or professional degree
Q14. Do you have any other comments you would like to share with us?
If you would like to receive $10 free play for completing the survey, please enter your players’ club number here.
