Client Feedback

Therapist:_____________________                                    
Date:____________                                                       
Client: ________________________

Your evaluation is assessed by the therapist and use as a teaching tool.
Circle all that apply

Quality:   Soothing   Firm   Hesitant              Other_______________

Depth:    Too Deep   Too Light   Just Right     Other_______________

Pace:     Rhythmic   Too Fast   Too Slow        Other_______________

I would receive a massage from this therapist again._______
I would not receive a massage from this therapist again, because:
__________________________________________________________________________________________________________________________________________________
_________________________________________________________________________

Please comment on any anxiety or discomfort about your treatment.
__________________________________________________________________________________________________________________________________________________
 ________________________________________________________________________

What did enjoy most about your treatment?__________________________________________________________________________________________________________________________________________________
_________________________________________________________________________

What could have made your treatment better for you?__________________________________________________________________________________________________________________________________________________
_________________________________________________________________________

Additional comments and suggestions:  __________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________
 ________________________________________________________________________

No comments:

Post a Comment