COVID-19 Consent Form
Email address *
Full Name *
Date of Birth *
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Phone number *
Address *
Have you been tested for COVID19? *
Date of test
MM
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DD
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YYYY
Results of Test
Clear selection
Do you have any of the following COVID-19 symptoms *
Required
Have you been in close contact with anyone with these symptoms, or anyone diagnosed with COVID-19 in the past 14 days? *
Have you traveled outside of the United States in the last 14 days? *
I knowingly and willingly consent to have this treatment despite the COVID-19 and social distancing climate. I understand that Sugar Sugar is not responsible for the exposure I may encounter via clients and staff. I will abide by salon sanitation guidelines including handwashing, face coverings, and all other safety procedures set by Sugar Sugar. *
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