Health & Fitness: Massage Therapy Eval
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1. Massage Therapy Evaluation
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1
. Massage Therapist Name
Massage Therapist Name
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2
. Date of massage
Date of massage
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3
. Type of massage
Type of massage
Sports
Deep Tissue
Swedish
Seated
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4
. Were you satisfied with the facility?
Were you satisfied with the facility?
Yes
No
Comments
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5
. Please rate the Massage Therapist in the following areas:
Poor
Fair
Average
Good
Excellent
Timeliness of Appointment
Please rate the Massage Therapist in the following areas: Timeliness of Appointment Poor
Fair
Average
Good
Excellent
Professionalism
Professionalism Poor
Fair
Average
Good
Excellent
Overall Knowledge
Overall Knowledge Poor
Fair
Average
Good
Excellent
Comfort Level
Comfort Level Poor
Fair
Average
Good
Excellent
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6
. Did your Massage Therapist review the client intake form with you?
Did your Massage Therapist review the client intake form with you?
Yes
No
Comments
7
. Did your Massage Therapist work the muscles you asked to be massaged?
Did your Massage Therapist work the muscles you asked to be massaged?
Yes
No
Comments
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8
. Are you likely to return for a massage? If no, why?
Are you likely to return for a massage? If no, why?
Yes
No
Comments
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9
. Would you recommend Massage Therapy through IM-Rec Sports to a friend, co-worker or family member?
Would you recommend Massage Therapy through IM-Rec Sports to a friend, co-worker or family member?
Yes
No
Comments
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10
. How did you hear about Massage Therapy at the AFC?
How did you hear about Massage Therapy at the AFC?
Website
Brochure
Word of Mouth
Other
Comments
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11
. The customer service at time of registration was:
The customer service at time of registration was:
Poor
Fair
Average
Good
Excellent
Comments
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12
. What did you like BEST about your Massage Therapy experience?
What did you like BEST about your Massage Therapy experience?
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13
. What did you like LEAST about your Massage Therapy experience?
What did you like LEAST about your Massage Therapy experience?
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14
. Please comment about your Massage Therapy experience overall:
Please comment about your Massage Therapy experience overall:
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15
. Sex
Sex
Male
Female
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16
. Please select all that apply:
Undergraduate
Grad Student
Faculty
Staff
Other
University Affiliation
Please select all that apply: University Affiliation Undergraduate
Grad Student
Faculty
Staff
Other
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