Client Survey
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1
. First Name:
First Name:
*
2
. When was you most recent appointment?
MM
DD
YYYY
Date:
When was you most recent appointment? Date: Month
/
Day
/
Year
3
. How would you rate your experience at Relaxing Palms Massage with these items?
Very Unhappy
Unhappy
Somewhat Unhappy
Not Sure
Somewhat Happy
Happy
Very Happy
Your massage:
*
How would you rate your experience at Relaxing Palms Massage with these items? Your massage: Very Unhappy
Your massage: Unhappy
Your massage: Somewhat Unhappy
Your massage: Not Sure
Your massage: Somewhat Happy
Your massage: Happy
Your massage: Very Happy
Comfort:
Comfort: Very Unhappy
Comfort: Unhappy
Comfort: Somewhat Unhappy
Comfort: Not Sure
Comfort: Somewhat Happy
Comfort: Happy
Comfort: Very Happy
Customer service:
Customer service: Very Unhappy
Customer service: Unhappy
Customer service: Somewhat Unhappy
Customer service: Not Sure
Customer service: Somewhat Happy
Customer service: Happy
Customer service: Very Happy
Facilities:
Facilities: Very Unhappy
Facilities: Unhappy
Facilities: Somewhat Unhappy
Facilities: Not Sure
Facilities: Somewhat Happy
Facilities: Happy
Facilities: Very Happy
4
. Additional Comments:
Additional Comments:
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