Client Health Declaration Form
In order for us to adhere to government guidelines pertaining to the COVID19 outbreak and to ensure our salons are and remain to be a safe environment for both staff and clients alike, we are asking all customers to complete the following form. After completion, a member of staff will make contact with you to assist you with your booking. If you are receiving this form, you are on our waiting list and a member of staff will call you. Please be patient as we have a lot of people to call. Thank You. Priya Team.
Email Address *
Full Name *
Phone Number *
I hereby certify that *
Required
How are you feeling Health wise? *
I hereby certify that *
Required
I hereby certify that *
Required
Are you considered to be in the COVID 19 'high risk' category based on age and/or medical grounds? *
I will let Priya know if my health status has changed before my appointment if i have filled this form more than 24hrs in advance of my appointment.
I will come to Priya wearing a mask and keep it on for the duration of my visit? *
I have read the information on www.priyatherapy.com about the terms and conditions of making an appointment and i am aware of the cancellation policy? *
If tinting or waxing, have you had it done within 12 months in our salon? *
NOTE: When in Priya, please adhere to our in-salon standard processes/procedures regarding infection control, i.e. hand washing/hand sanitising and general coughing/sneezing etiquette?
Private Data Protection Notice: This data sheet will be stored confidentially and is not shared with any third party, unless there will be an official request by the local authorities for reasons of public interest in the area of public health.The datasheet will be deleted one month after collection, unless a longer period is required by the public authorities.Thank you for your cooperation!
Please Accept *
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