| Month & Year of Service:
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| Massage Therapist:
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Massage Type:
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| Professional Conduct: |
| 1. The therapist greeted me and was friendly.
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| 2. The therapist behaved in a professional manner throughout the appointment.
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| Quality of Service: Please rate the quality of each part of the service. |
| 1. The therapist treated my areas of concern (if any) to my satisfaction.
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| 2. The therapist was sensitive to my comfort level and needs.
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| 3. I would recommend this service to others.
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| Comments: |
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