Enter Drawing for Three Hours of Professional Massage (!!) at the Chrysalis Massage Clinic
Fill out the following survey and mail to:
Ashland Institute of Massage | P.O. Box 1233 | Ashland, OR 97520
or drop it by our office between 9am and 5pm:
280 E. Hersey St. Suite A-8 (in the Hersey St. Business Park).
What is your age?
____ under 25 ____ 26 – 50 ____ 51 – 70 ____ over 70
How often do you receive massage?
____ Never____ less than 1/year ____ 1 – 12 times/year ____greater than 1/month
What is your primary reason to seek massage?
____ Relaxation & stress reduction____ Relief from pain____ Injury rehabilitation ____ It feels great!____ General wellness care ____ Other:
How do you choose a massage therapist?
____ Local advertising____ Casual word-of-mouth ____Personal recommendation
Please rate the importance (1 – 5) of the following qualities in your choice of a massage therapist:
____ Price ____ Location____Clinic/Office Atmosphere ____Quality of Massage ____ Personality of Therapist
Name:
Address:
Email:
Phone:
I would like to be on the mailing list for the Chrysalis Clinic to receive information about periodic specials: yes____ no_____
Thank You and Good Luck! * Drawing will be held on September 18th.
The winner will be contacted and announced in our column in the October issue of the Locals Guide.
