Massage/Facial Feedback Form

Our goal is to provide clients with the best possible experience and we appreciate your willingness to take the time to give us honest feedback.

Please rate each of the questions on a scale of 1-5 (where 1 is poor and 5 is excellent) and provide additional comments or suggestions in the “Additional Comments” field.

Your contact information is optional, but if you would like us to contact you for further discussion about your experience, please include either an e-mail address or phone number.

*(denotes required field)

Name:

E-Mail Address:

Phone:

Please contact me to discuss my experience *

No
Yes

Name of therapist

Date and time of my appointment *

The overall atmosphere, cleanliness, and quality of the facility was professional and relaxing.

--please select-- 1 (poor) 2 3 4 5 (excellent)

My therapist was friendly, knowledgeable, and professional.

--please select-- 1 (poor) 2 3 4 5 (excellent)

My therapist started and ended the session on time.

--please select-- 1 (poor) 2 3 4 5 (excellent)

My therapist followed the session plan we agreed on and I received the treatment I asked for.

--please select-- 1 (poor) 2 3 4 5 (excellent)

My therapist communicated and listened to me during the session.

--please select-- 1 (poor) 2 3 4 5 (excellent)

My payment was processed in a timely manner and I was given the opportunity to book a future appointment at the end of the session.

--please select-- 1 (poor) 2 3 4 5 (excellent)

My overall experience was excellent and I would come back.

--please select-- 1 (poor) 2 3 4 5 (excellent)

Additional Comments

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