COVID-19 Initial Client Wavier
By completing and submitting this form, you are knowingly and willingly consenting to having beauty care services performed during the COVID-19 Pandemic and you agree to adhere to all safety and sanitation protocols by Shear Designs II salon's service provider.
Email *
First Name *
Last Name *
Phone Number *
I am aware that due to limited testing for the COVID-19, the virus has a long incubation period during which time carriers of the virus may be asymptomatic (no symptoms) and still be highly contagious. I also acknowledge that it is impossible to determine who has it . *
Required
I also acknowledge that I understand that anytime I am within close proximity (less than 6ft) of my service provider or any other person, I could have an elevated risk of contracting the virus should it be present. *
Required
I confirm that none of the following COVID-19 symptoms have been present within the last 1-14 days: Fever *
Required
I confirm that none of the following COVID-19 symptoms have been present within the last 1-14 days: Shortness of Breath *
Required
I confirm that none of the following COVID-19 symptoms have been present within the last 1-14 days: Loss of taste or smell *
Required
I confirm that none of the following COVID-19 symptoms have been present within the last 1-14 days: Dry Cough *
Required
I confirm that none of the following COVID-19 symptoms have been present within the last 1-14 days: Sore Throat *
Required
I affirm that I have not been exposed to anyone that has been diagnosed with COVID-19 within the past 14 days inside or outside of the country I reside in. *
Required
I affirm that I have not traveled domestically (outside of my state) or internationally (outside of my country) within the past 14 days. *
Required
Do you suffer from allergies? If yes, explain what are your allergy symptoms. If no, then put "Not Applicable or N/A" below. *
Select your stylist name *
Date *
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I agree by providing my name below, I am in essence rendering my signature in acknowledgement of the completed statements on this form and that all information is accurate as of the date of this form. *
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