Hair Lab & Co. Covid-19 Pre-Screening

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With recent events, we ask for you to fill out this form honestly for the safety of everyone! Please fill out this document prior to your appointment and help stop the spread of Covid-19 <3

First and Last Name *

Email Address *

Phone Number *

Have you been asked to recently isolate my a medical official? *

Yes

Have you come into contact with anyone who displayed possible symptoms of Covid-19 in the last 14 days? *

Yes

Have you come into contact with anyone who has tested positive for Covid-19? *

Yes

Have you travelled outside of Ontario or Canada in the past 14 days? *

Yes

Do you have any of the following symptoms listed below that could be related to Covid-19? *

No Symptoms of Covid-19

Coughing

Sore Throat

Shortness of Breath

Fever

Decrease or loss of taste and/or smell

Chills

Headache

Hoarse voice

Sneezing (Non Allergy)

Runny/Stuffy/Congested Nose

Unexplained Fatigue/Tiredness

Muscle Aches

Nausea or Vomitting

Difficulty Swallowing

Abdominal Pain

Diarrhea

Pink Eye

Other

Required

You've Completed Your Covid-19 Pre-Screening for Hair Lab & Co.

Please wait for a confirmation for further instructions before entering the studio!

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