Skip to content
Call Us Today! 844-687-7222
Relational Bodywork Program
About Massage Therapy
About Somatic Psychology
Awareness & Bodywork Blog
The Ultimate Guide for getting a Massage Therapy License
The Ultimate Guide to Choosing a Massage School
Somatic Psych History
Make a Payment
Structural Integration 10-Series DVD
" indicates required fields
You have been listed as a reference by an applicant to our 8-month bodywork program. We want to make enrollment decisions that are best for the applicants and maximize fitness for our program. We recognize that it can be tempting to have a positive bias on these forms to help the applicant, but also keep in mind that their ideal path may not be joining this program. Your honest answers will help us determine the best path forward. Thank you.
Relation to Applicant
In what capacity do you know this person?
How long have you known the applicant?
Does the applicant tend to finish what they start?
Half the time
What level of engagement to do you imagine the applicant will maintain with our program's material?
How would you rate the likelihood that this applicant will have good attendance and punctuality?
How healthy is the applicant's relationship with conflict?
Healthy=Actively attempts to resolve conflict. Takes responsibility for mistakes. Doesn't avoid or add to conflict.
Unhealthy=Generates or avoids conflict. Blames others. Doesn't take responsibility and doesn't attempt to create resolution.
Worse than average
Better than average
How would you characterize the applicant's response to feedback or critique?
Poor responses include defensiveness and unwillingness to consider feedback. Good responses include appreciation and a desire to improve based on what is offered.
How much does the applicant naturally consider his/her behavior's impact on others?
Please base this decision on the applicant's actions, not on what they say.
When the applicant is upset about something or upset with someone, which of the following actions do you imagine the applicant would normally take?
Publicly discuss the issue on social media
Discuss with friends but not relevant parties
Keep issue to oneself
Discuss with relevant parties
Please offer any other comments about the applicant that you think would be useful in our decision-making process.
Thank you for taking the time to complete this form.
Total Score out of 35
Page load link