Massage Services Feedback Form Name * First Name Last Name Email * Today's Date * MM DD YYYY Type of Massage * Chair Table Were you greeted in a courteous manner? * -Select One- Yes (warm fuzzy) No (cold prickly) Did the therapist explain all the areas they were going to cover? * -Select One- Yes No Did the therapist ask if you were comfortable before beginning treatment? * -Select One- Yes No Was the amount of communication appropriate? * Consider both explanation of treatment and banter... -Select One- Yes No Okay, but could have added more Okay, but could have toned it back a bit Was there enough variety in massage techniques? * -Select One- Yes No Did the therapist keep their hands on you all or most of the time? * -Select One- Yes No Did the massage seem to have a good flow? * -Select One- Most of the time Some of the time Like Elaine from Seinfeld dancing Did the therapist make you feel uncomfortable at any point? * -Select One- Yes No If yes, explain Therapist's Personality * (Scale of 1-5, 5 being the best) -Select One- 1 2 3 4 5 In general, evaluate the effectiveness of the massage * (Scale of 1-5, 5 being the best) -Select One- 1 2 3 4 5 Would you ever make an appointment with this therapist out in public * -Select One- Yes No Therapist strong points... Therapist weak points (please give one area for improvement) Additional Comments/Questions Thank you!
