JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
CV-19 Safe Salon Client Revist Form
This form is to be used as an individual client record for salon guest each time they visit the salon or shop for their scheduled service appointment. It is required to ensure that during the COVID-19 Pandemic, there are no symptomatic signs of the virus during this service visit. You will provide this form to Healthy Concepts Hair & Beauty Center 115 Forest Hill Ave
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Proper Handwashing
First Name
*
Your answer
Last Name
*
Your answer
Client's Temperature This Service Visit:
Your answer
Do you have any of the following symptoms present today: Fever, Shortness of Breath, Runny Nose, Loss of sense of taste or smell, Dry Cough, Sore Throat, Chills, Shaking with Chills, Muscle Pain, Head Ache
*
Yes
No
Have you been in contact with anyone that has been diagnosed with the COVID-19 virus during the time between this service visit and my previous service visit?
*
No, I have not
Yes, I have
Signature (Write Below)
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
