Questionnaire
salon esprit requires you to complete the questionnaire before entering the store. For the safety of our customers and staff.
What is your name? *
Date of entry *
MM
/
DD
/
YYYY
Appointment Time *
Time
:
Within the last 2 weeks, I have come in contact with a person who has/had COVID-19. *
I have been outside of CANADA. I have been in contact with a person(s) who travelled outside of Canada. *
I have flu-like symptoms such as coughing, fever and/or sneezing. *
Within the last 2 weeks, I’ve had a 37.5C+ fever. *
I have been to traveled outside of CANADA within 14 days. I have been to contact with someone who has traveled outside of CANADA within 14 days. *
Explanation
※Depending on your answers to the questions above, we ask for your understanding that we may have to decline our service to you.

In order to follow the guidelines of preventing the spread of COVID-19, the conversations must be kept minimal.
What is your email address? *
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