Load Accessibility Friendly Version
The Kroger Co. is committed to providing you excellent customer service.
We value your candid feedback and appreciate you taking the time to complete our survey.
Please fill in the following information from your receipt.
Date: -- 010203040506070809101112 / -- 01020304050607080910111213141516171819202122232425262728293031 / -- 2021
Time: -- 010203040506070809101112 : -- 000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 -- AMPM
Store Number (4-digits):
Lane Number (2-digits):
Transaction Number (4-digits):
