MASSAGE INC. | Client Interest Survey

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please answer each question.

1. Massages offer a wide range of health benefits including improved circulation, pain relief and improved sleep. Given this, how interested would you be in receiving a weekly massage? *

Not Interested

Very Interested

2. Our Chair Yoga instruction has been designed to improve balance and assist in fall prevention. Given this, would you be interested in receiving weekly Chair Yoga instruction? *

Not Interested

Very Interested

3. Would it be of value to you as a resident to be assured that your massage therapist is only working at your senior living community and no other? *

Not Important

Very Important

4. Would you prefer to pay for the services directly at the time of service or have them included in your rent? *

Pay at Time of Service

Included in Rent

5. Would you prefer to have an in-house massage therapist or potentially wait extended periods of time for an appointment? *

In-House Massage Therapist

By Appointment

6. Would it be preferable for you to have an in-house Yoga Instructor for sheduled Yoga sessions or by appointment? *

In-House Yoga Instructor

By Appointment

7. Would you prefer to have a massage in your private room or would you enjoy going to your community's spa room? *

Private Room

Community Spa

8. Would you be able to comfortably get on and off a massage table without assistance? *

No Assistance

Fully Assisted

9. What would you consider paying for a quality massage? *

40 - 50

60 - 70

70 - 80

80 +

10. What would you consider paying for a senior specific Chair Yoga session? *

20 - 30

30 - 40

40 - 50

50 +

Clear form

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms