BLOW+BAR Health Declaration
Dear clients, your health and well-being is of outmost importance to us. In view of the Wuhan coronavirus in China, we require all clients to complete a health declaration form as part of Blow+Bar's precautionary measures.

We declare that all our staff have not travelled to China in the past 1 month and will take precautionary measures for hygiene and cleanliness.
I acknowledge and consent to the collection, use and disclosure of my personal data by Blow+Bar for the purposes set out in the above notice. *
Required
Date of visit *
MM
/
DD
/
YYYY
Name *
Your answer
Contact Number *
Your answer
Have you travelled to China in the past 14 days? *
Have you travelled overseas in the past 14 days? *
Are you currently experiencing any of the symptoms? *
Required
I declare the above is true and accurate. *
Required
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