Emerge Medical Day Spa

customer feedback survey

9124 S. Sheridan Road
tulsa ok 74133
Schedule an Appointment

918-392-8606

MedForm

Highly
Agree

Highly
disagree

My treatment was explained to me

I was asked if I had any questions prior to my treatment

I feel like all of my questions and concerns were addressed

The products used on my skin were explained to me

I enjoyed my treatment today

* Required Question(s)

Thank you for your recent visit to the spa. We would appreciate any feedback you have. Please read the attached survey and complete to the best of your ability.

1. Which of the following services did you receive on your most recent visit?

Check all that apply.

Massage/Body Treatments	Facials/Waxing	Chemical Peels
Laser Hair Removal	Laser Services (other than Laser Hair Removal)	Botox or other facial injections
Eyelash Extensions	Medical Weight Loss	Product Purchases
Other

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* 2. Which staff member did your treatment today?

Tara (Aesthetician)	Chrystal (Aesthetician and Massage Therapist)	Adriana (Massage/Body treatment Therapist)
Belinda (Nurse)	Andrea (Physician's Assistant)	Suzanne (Laser Hair Removal)
Dr. Childers	Other

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* 3.Please rate the following attributes of the service you received today.

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4.Please rate your agreement with each of the following statements about the staff.

	Strongly disagree	Somewhat disagree	Neutral	Somewhat agree	Strongly Agree	N/A
The staff is professional
The staff is knowledgeable about the products
The staff is attentive to my needs
The staff is courteous and polite
The staff provides helpful suggestions
The staff lets me take my time shopping without feeling rushed
The staff lets me choose what fits my needs without feeling pressured

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5.How likely are you to shop with us in the future?

	Very likely		Somewhat likely		Neutral
	Somewhat unlikely		Very unlikely

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6. Please leave any suggestions you may have as well as any feedback you would want us to know about.
We appreciate it! Make sure to include your name for a 10% coupon to be sent to you for completing this survey.