Which location did you visit?
MADISON AVENUE    57^TH STREET

What beauty treatment did you receive? Aquarejuvenation™ Bikini Wax Body Massage Chemical Peel Classic Facial Endermologie Facial Lift 6 Cosmecanique® Microdermabrasion Oleaslim Slimming System Organic Facials Oxygen Facial Reflexology Sudatonic Slimming System™ Swedish Miracle Wrap Slimming System Tri-Active LaserDermology™

Name of Technician, Aesthetician or Doctor (see card): 

Date of Visit:

1) How was your overall Cellulite Center at Luminesa Medi-Spa experience?
Please select one Terrific Great Good Satisfactory Poor
(Please comment on reception, ambience, décor and timing.)

2) How was the service quality?
Please select one Terrific Great Good Satisfactory Poor
(Please comment on our staff's performance, technical skill and overall knowledge of spa treatments—and on your results.)

3) How can we make your experience better?
(Please comment on any aspect of your visit.)

4) How did you hear about Cellulite Center at Luminesa Medi-Spa?
(Example: From Google, CitySearch, Spa Week, through a friend, or just walked in, etc.)

5) Is this the first time you are filling out this review?
Yes   No

(You can accept a new 15% Gift Card every time you visit Cellulite Center at Luminesa Medi-Spa,
but you need to complete this feedback form and get a new code each time.)