Client Survey - Post-Session

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Client Survey - Post-Session

Postby pueppi on Mon Mar 25, 2013 1:39 pm

I will be providing a number of Case Studies over the next few months, since completing a Lymphatic Drainage Course (see thread here about lymphatic drainage courses).

In conjuction to creating a Case Study Consultation Form for MLD --- {which includes things like a series of check off boxes for the Personal Details/Data, Contraindications, Local Contraindications, Other Potential Contraindications, Personal Information (Health History and Review of Systems) - along with data to be documented by the therapists such as Client Profile (Including Lifestyle), Treatment Plan & Session, Client Feedback (Immediately After the Session), Home Care Advice Given & Self Reflection} --- I have also created a Post-session Survey.

Since we've been talking about this in another thread, I thought I would add it here. It is, of course, subject to change as I get deeper into the work.

I hope it is helpful to someone.

If anyone else has a survey (for any sessions or modalities), please feel free to add them here. :)




POST-MLD Survey – Date _________

1. Did you enjoy your session?
□ Yes
□ No


2. Was your experience with MLD a positive one?

□ Yes
□ No


3. How long do you feel the effects of your MLD therapy session lasted?

□ 1 – 4 hours.
□ 4 – 8 hours.
□ 8 – 24 hours.
□ More than 24 hours.
□ No effect.


4. How do you feel the MLD therapy session helped your ability to relax?

□ Improved.
□ Had no effect.
□ Worsened.


5. How do you feel the MLD therapy session helped your overall emotional well-being?
□ Improved.
□ Had no effect.
□ Worsened.


6. How do you feel the MLD therapy session helped your ability to be patient with others?

□ Improved.
□ Had no effect.
□ Worsened.


7. How do you feel the MLD therapy session helped your ability to move / range of motion?

□ Improved.
□ Had no effect.
□ Worsened.


8. How do you feel the MLD therapy session helped your activities of daily living / daily functioning?
□ Improved.
□ Had no effect.
□ Worsened.


9. How do you feel the MLD therapy session helped your overall pain levels?

□ Improved.
□ Had no effect.
□ Worsened.
□ I did not have any pain initially


10. How do you feel the MLD therapy session has affected your need for pain medication?

□ Decreased.
□ No change.
□ Increased.


11. How do you feel the MLD therapy session helped your ability to sleep?

□ Improved.
□ Had no effect.
□ Worsened.


12. How do you feel the MLD therapy session helped your recovery?

□ Improved.
□ Had no effect.
□ Worsened.
□ Not applicable.


13. Do you plan to continue using Manual Lymphatic Drainage (MLD) therapy in your healing process?

□ Yes
□ No
□ Maybe
May your trails be crooked, winding, lonesome, leading to the most amazing view. May your rivers flow without end, meandering through valleys tinkling with bells...
Houston Massage Therapy - Advanced Massage Therapy - Lucas & Lucas, LLC
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pueppi
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Location: Texas / The Lone Star State

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