Student Evaluation Form
Name: ___________________ Teacher:
Date : ___________________ Title of Work: ___________________
 
Criteria
Points
1
2
3
4
 
Appearance of the Clinic
The overall facility was cluttered, unprofessional and noisy.
The overall atmosphere, cleanliness, and quality of the facility was lacking in professionalism and relaxation.
The overall atmosphere, cleanliness, and quality of the facility was somewhat professional and relaxing.
The overall atmosphere, cleanliness, and quality of the facility was professional and relaxing.
____
Student Massage Therapist
The therapist was unprofessional, rude, and seemed uneducated throughout the entire session.
The therapist was somewhat unprofessional, unfriendly, and lacked knowledge throughout the most of session.
The therapist was professional, friendly, and knowledgeable throughout most of the session.
The therapist was professional, friendly, and knowledgeable throughout the entire session.
____
Intake Process
The therapist failed to consult me about my massage preferences. Did not discuss the degree of pressure or the areas of body I wanted focused on.
The therapist briefly discussed the massage I would be receiving, but failed to address the degree of pressure I would expect and the areas of the body I wanted focused on.
The therapist consulted with me about the type of massage I wanted to receive, and briefly discussed the degree of pressure I expected, and the areas of my body where I wanted focus.
The therapist consulted with me about the type of massage I wanted to receive.Including the degree of pressure I expected, and the areas of my body where I wanted focus.
____
Massage Session
The therapist did not follow the treatment plan we agreed on and never asked about degree of pressure
The therapist somewhat followed the plan we agreed on. The therapist lacked confidence. The massage was choppy and lacked the pressure desired.
The therapist followed the plan we agreed on during the intake process. They occasionally asked about the degree of pressure and adjusted it when necessary. The massage strokes adequately fit the needs of my body.
The therapist followed the plan we agreed on during the intake process. They asked about the degree of pressure and adjusted it when necessary. The massage strokes felt firm, flowing, confident and appropriate to the needs of my body.
____
Overall experience
My overall experience was poor and I will not return. I would like to speak to the clinic supervisor to further discuss.
My overall experience was subpar. I may not return.
My overall experience was good and I will come back.
My overall experience was excellent and I will come back.
____
       
Total---->
____

Teacher Comments:

 


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