Massage Attitudes
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1. Massage History
25%
*
1
. Have you ever had a professional massage?
Have you ever had a professional massage?
Yes
No (skip to next page)
2
. How long ago was your last professional massage?
How long ago was your last professional massage?
less than 1 week
less than 1 month
less than 6 months
less than 1 year
more than 1 year
more than 5 years
3
. What prompted you to seek your last massage?
(check all applicable reasons)
What prompted you to seek your last massage? (check all applicable reasons)
relaxation
stress relief
relieve tense muscles
pain relief
accident/injury rehabilitation
enhance sports performance
pampering/"me time"
received gift certificate
had a doctor's prescription
celebrate special occasion
spa day with friends or loved ones
weight loss
improve body image
escape
Other (please specify)
4
. Where have you experienced massage?
Where have you experienced massage?
chiropractic office
day spa
destination/hotel/resort spa
gym/health club
physical therapy office
private office
salon
therapist came to my home or hotel room
wellness clinic (not otherwise specified)
workplace
Other (please specify)
5
. If you used any other services with your massage, please check the appropriate box(es) below:
If you used any other services with your massage, please check the appropriate box(es) below:
acupuncture/TCM
allopathic/osteopathic medicine (MD/DO)
aromatherapy
body scrubs
body wraps
chiropractic treatment
energy medicine (e.g. Reiki, Polarity Therapy, Shamanic Healing)
esthetics/facial
exercise (not proscribed for therapy)
hair removal
hair styling/coloring
hot or cold packs
hydrotherapy tub/soak
manicure/pedicure
naturopathic medicine (ND)
physical therapy
rehabilitative exercises
sauna/steam room
tanning
Other (please specify)
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