Client Feedback Form

Your feedback is important to RelaxAmerica Massage! 
To ensure your satisfaction and to assist me in giving you the best possible service, please take a few moments to tell me about your experience with RelaxAmerica Massage.  

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Name:
   Email Address:
 Session Date 
 
I receive the desired results from my massage therapy session. Yes No
 If no, please explain

Was there something that you particularly enjoyed?
Yes No
  please explain

Was there anything that you did not enjoy?
Yes No
  please explain

What is it about me or my services that makes you choose RelaxAmerica Massage for massage therapy? 

What words would you use to describe what is unique or special about me or my service?


I feel the prices for this type of service are fair.
Yes No
 If no, please explain

How could I change my services to work better for you?
 Suggestions

Sharing the Gift of Relaxation

We value your continued enjoyment of our services. Nothing compliments me more than a positive word of mouth recommendation and referrals. To thank you I offer discounts and special gifts to our clients who allow me to bring my vision of a relaxed America to friends, family and co workers. 

Do you have any friends you feel would benefit from and would be interested in receiving a massage?

Name   e-mail   Phone   Ext.

 Name   e-mail   Phone  Ext.
 

Would you be interested in having RelaxAmerica Massage come to your office for on site massage?

Yes   No  Maybe Later

 If so, please provide contact information of the individual responsible for employee benefits so we may inform them about our unique on site corporate massage packages. 

Name 
  Title  

Phone 
..  Ext.


 If a health day is booked by your employer, you will receive a gift certificate
for a complimentary massage as our thank you!

 



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