Iron Ink Tattoos COVID-19 Health Form
Email *
Legal First and Last Name *
In the past 14 days, have you... *
Had symptoms of COVID-19 such as cough, fever, or shortness of breath?
Had close contact with an individual diagnosed with COVID-19?
If you refuse to submit this form or if you answered "Yes" to any of the questions above, the proprietor has the right to refuse service. If you answered Yes to any of the questions above, please see the local health department's recommendations for COVID-19 screening and emergency help.
A copy of your responses will be emailed to the address you provided.
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