Satisfaction Survey

Overall Experience
How would you rate your overall experience?
Poor Below Average Average Above Average Excellent
Did the therapy room meet your expectations in the following areas?
Room temperature
Strongly disagree Disagree Neutral Agree Strongly agree
Music selection
Strongly disagree Disagree Neutral Agree Strongly agree
Comfort of client table
Strongly disagree Disagree Neutral Agree Strongly agree
Privacy
Strongly disagree Disagree Neutral Agree Strongly agree
Lighting
Strongly disagree Disagree Neutral Agree Strongly agree
Aroma
Strongly disagree Disagree Neutral Agree Strongly agree

Massage Services
Met my expectations
Strongly disagree Disagree Neutral Agree Strongly agree
Review of history and clinical needs was comprehensive
Strongly disagree Disagree Neutral Agree Strongly agree
Pressure application during massage was appropriate
Strongly disagree Disagree Neutral Agree Strongly agree
Use of therapeutic modalities was helpful (moist heat/cold therapy)
Strongly disagree Disagree Neutral Agree Strongly agree

Other Questions
Ease of scheduling appointment
Poor Below Average Average Above Average Excellent
Pricing for services
Less expensive Average More expensive
Comments / Suggestions

Name
First Last Name or Initial
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Overall Experience