Qi Foot Spa (COVID-19 FORM)
Due to COVID-19, all Qi Foot Spa customers are REQUIRED to fill in this form before their appointment. The guideline of reopening Massachusetts said, "Maintain a log of workers and customers to support potential contact tracing" (mass.gov). Your appointment might be canceled if you don't fill in this form before your appointment, we're sorry in advance, but have to follow strict standards to prevent the spread of COVID-19. Thank you understanding! Note to customer: Please wear a mask before entering.
Email address *
Name (first and last) *
phone number *
Date and time of appointment (when it starts and ends) ex: 7/21/20, 2-5pm
Do you show any symptoms of COVID-19 or been in contact with anyone with COVID-19? *
Do you agree to wear a mask while on this property (covering nose and mouth)? -unless you prefer to not wear a mask while facing down on massage table? *
Have you been outside of Massachusetts or anywhere that has high infection rates in the past 14 days? *
Do you want to receive email promotional offers (like special discounts)? *you can always opt out by emailing us+ we don't do promotions often
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