Massage Therapist Evaluation (NWC)

Please mark the following statements with the most appropriate values. These values show the extent to which you believe your assistant has shown their level of dedication.

  • (Please enter the first and last name of your assistant, ex. John Smith)
  • (Please enter the number of total days attended, ex. 30)
  • (Please enter the number days absent, ex. 2)
  • (Please enter the number days tardy, ex. 1)
  • (PLEASE NOTE: A total of 100 hours is required.)

  • Practical Experience In:

  • Personal Traits & Appearance:

  • (If you have any other comments please leave them in this box)
  • (Please enter your name, ex. Dr. James Brown)
  • (Please enter your e-mail address)
  • (Please enter the business name of the company/hospital you work for, ex. St. Joseph's Hospital)
  • - -
    (Please enter your telephone number)