• Applicant Information

• First and Last Name of Applicant
  
  First
  
  Last
• Applicant Photo
  • 
    Yes
  • 
    No
• File
  Drop files here or
  Select files
  Accepted file types: jpeg, png, pdf, jpg, Max. file size: 100 MB.

• Applicant Shirt Size
  • 
    X-Small
  • 
    Small
  • 
    Medium
  • 
    Large
  • 
    X-Large

• Applicant's Supplies

• Massage Table
  • 
    Yes
  • 
    No
• Condition
  • 
    Good
  • 
    Bad
• Please Explain
• Massage Chair(Optional)
  • 
    Yes
  • 
    No
• Condition
  • 
    Good
  • 
    Bad
• Please Explain
• Wheeled Cart or Table Carrier
  • 
    Yes
  • 
    No
• Condition
  • 
    Good
  • 
    Bad
• Please Explain
• Massage Equipment BagTote, backpack, luggage etc, needs to be solid dark color
  • 
    Yes
  • 
    No
• Condition
  • 
    Good
  • 
    Bad
• Please Explain
• Bag for Massage Table
  • 
    Yes
  • 
    No
• Condition
  • 
    Good
  • 
    Bad
• Please Explain
• Matching white/natural color sheets
  • 
    Yes
  • 
    No
• Condition
  • 
    Good
  • 
    Bad
• Color Used
• Please Explain
• Speaker
  • 
    Yes
  • 
    No
• Music(Separate speaker from music player is suggested. iPod, iPad, MP3, Cell, No computers)
  • 
    Yes
  • 
    No
• Uninterrupted Playlist(Commercial-free streaming)
  • 
    Yes
  • 
    No
• Oil(Optional)
  • 
    Yes
  • 
    No
• Lotion(Hypoallergenic)
  • 
    Yes
  • 
    No
• Bolster
  • 
    Yes
  • 
    No

• Applicants Items Needs

• Items to be Purchased
  • 
    Massage Table​
  • 
    Music (Separate speaker from music player is suggested. Can be iPod, iPad, MP3,Cell phone, No computers)
  • 
    Massage Chair (Optional if you would like to perform chair massage)
  • 
    Speaker
  • 
    Wheeled Cart
  • 
    Uninterrupted Playlist (Commercial-free streaming)
  • 
    Massage Equipment Bag (Tote, backpack, luggage etc)
  • 
    Lotion (Hypoallergenic required)
  • 
    Matching Natural White/Solid Colored Sheets
  • 
    Oil (Optional)
  • 
    Table Cover/ Bag for Massage Table
  • 
    Bolster
  • 
    Other
• Please Explain

• Modalities

• Modalities Certified In(Ones willing to perform)
  • 
    Aromatherapy
  • 
    Chair (Must have own chair & willing to do events up to 4 hours)
  • 
    Craniosacral
  • 
    Cupping (Must have own cups)
  • 
    Deep Tissue
  • 
    Elderly
  • 
    Hot Stone (Must have own stones)
  • 
    Lomi Lomi
  • 
    Myofascial
  • 
    Neuromuscular
  • 
    Prenatal
  • 
    Reflexology
  • 
    Reiki
  • 
    Shiatsu
  • 
    Sports
  • 
    Swedish
  • 
    Thai
  • 
    Trigger Point
  • 
    Other
• Please Explain

• Prior to Massage

  Rate on a scale of 1-10

• AppearancePlease enter a number from 1 to 10.
• Rating
  • 
    Good
  • 
    Bad
• Please Explain
• SpeechPlease enter a number from 1 to 10.
• Rating
  • 
    Good
  • 
    Bad
• Please Explain
• Self ConfidencePlease enter a number from 1 to 10.
• Rating
  • 
    Good
  • 
    Bad
• Please Explain
• Quality of SuppliesPlease enter a number from 1 to 10.
• Rating
  • 
    Good
  • 
    Bad
• Please Explain

Save and Continue Later

• Post Massage

  Rate on a scale of 1-10

• Asked Pre-Massage questions about bodyPlease enter a number from 1 to 10.
• Rating
  • 
    Good
  • 
    Bad
• Please Explain
• Supplies kept neatly in a corner or spread out?Please enter a number from 1 to 10.
• Rating
  • 
    Good
  • 
    Bad
• Please Explain
• ResponsivenessPlease enter a number from 1 to 10.
• Rating
  • 
    Good
  • 
    Bad
• Please Explain
• MannersPlease enter a number from 1 to 10.
• Rating
  • 
    Good
  • 
    Bad
• Please Explain
• How did they start? Were you face down?Please enter a number from 1 to 10.
• Rating
  • 
    Good
  • 
    Bad
• Please Explain
• How did they move from one appendage to the next? Even, smooth process?Please enter a number from 1 to 10.
• Rating
  • 
    Good
  • 
    Bad
• Please Explain
• Did they make you feel comfortable?Please enter a number from 1 to 10.
• Rating
  • 
    Good
  • 
    Bad
• Please Explain
• Even pressure on both sides? Consistency? Capable of deep tissue?Please enter a number from 1 to 10.
• Rating
  • 
    Good
  • 
    Bad
• Please Explain
• Did they drape properly?Please enter a number from 1 to 10.
• Rating
  • 
    Good
  • 
    Bad
• Please Explain
• Knowledge of Anatomy?Please enter a number from 1 to 10.
• Rating
  • 
    Good
  • 
    Bad
• Please Explain
• Enough time to change/get on/off the table?Please enter a number from 1 to 10.
• Rating
  • 
    Good
  • 
    Bad
• Please Explain
• Timeframe? Did they start and finish with in allotted time?Please enter a number from 1 to 10.
• Rating
  • 
    Good
  • 
    Bad
• Please Explain
• How did they finish? Smooth finish? Did they let the client know it was over?Please enter a number from 1 to 10.
• Rating
  • 
    Good
  • 
    Bad
• Please Explain
• Additional Comments(Appearance, anything offensive to potential clients, cleanliness etc…)
• In your professional opinion, would you want this person massaging you?
  • 
    Yes
  • 
    No
• Why?

Save and Continue Later