Learners Name (required)

Assessment Date (required)

Location (required)

Tutors Name (required)

Assessor Name (required)

Did the learner explain the treatment to the client? (required)

Effectiveness of the effleurage move (required)

Effectiveness of the petrissage move (required)

Effectiveness of the tepotement move (required)

Did the learner manage the amount of medium used? (required)

How was the learners towel control? (required)

How was the learners posture during the treatment? (required)

How was the speed of the treatment? (required)

Which of the following did the learner complete?

Give details on the Posture Analysis? (required)

Feet Cleanse
Arms massage
Arm stretches
Front of legs massage
Leg stretches
Feet Massage
Abdomen Massage
Face massage
Neck Massage
Neck stretches
Back of leg massage
Back massage

Please select Yes or No

YesNo   -  Did the learner show empathy to the client?

YesNo   -  Did the learner check to see if the pressure was ok?

YesNo   -  Did the learner check to see if the client was warm enough?

YesNo   -  Did the learner offer any aftercare advise?

YesNo   -  Did the learner offer the client a drink after the treatment?

Please leave any comments / additional notes feedback.

From Assessor

From The Model

From The learner

Final Decision
In your capacity as an Assessor, do you feel that the learner meets the assessment requirements and is safe to practice this therapy?

YesNo