Form: Student Reports for Receiving Massage

Practitioner's Name:

Recipient's Name:

Date:

1. Did your practitioner take time before your massage to ask if you have any special needs, old or new injuiries, and what depth of touch you like? Did your massage reflect what was discussed?

2. Did your massage have an overall sense of integrity, wholeness, and flow? Did your practitioner use long, flowing strokes as a means of creating this sense of wholeness in your massage?

3. Did your practitioner occasionally ask you how the depth of the work was for you, and if you were warm enough?

4. Was your practitioner conscious of adequately draping you during your massage?

5. Please take time to make any additional comments you have about this massage experience.

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