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Appointment date
Did you feel heard and were you given the help needed?
Yes
No
Were questions clearly answered?
Yes
No
Not applicable
Was the office in and out of the massage room quiet enough?
Did you feel safe and comfortable?
Yes
No
Rate amount of talking in session.
Too much
Not enough
Just right
Comment on bolster/sheets/ table (chair if seated).
Did you like follow-up call/email?
Yes
No
I did not receive one.
What you think matters. Please comment about your treatment.
I'd like my next massage $5 off. Please call so I can schedule.
( Eg. 111-111-1111 )
Your Name (optional)
Massage Available in Celebration, Florida 34747
407-566-8852
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