Trace and Protect Client Questionnaire

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As part of Celtic Wellbeing’s new Covid Health and Safety protocols, we would ask that you complete this form 24 hours in advance of coming into the Salon for your treatment. This is to ensure that we protect both our clients, staff and wider community in stopping the further spread of the Covid-19 virus.

Please complete the questions below, honestly and accurately.

Appointment Guidance

Please only attend at your appointment time.

Please ensure you are on time - if you are late this may result in your appointment being cancelled

Please attend your appointment unaccompanied

Please limit the personal possessions you bring with you (leave securely in your car where possible)

We ask that you observe social distancing and hygiene protocols at all times

Upon arrival you must use the hand sanitiser provided.

Our team will, as you would expect be wearing relevant PPE, including masks, face shields, aprons and gloves. You will be provided with a disposable mask to wear whilst your treatment is taking place.

CONTACTLESS payments only unless you have made payment prior to your appointment

If you experience Covid-19 symptoms after your appointment please contact us immediately

Booking date *

YYYY

Option 1

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Please enter your first name *

Surname *

Please supply us with your home telephone number (If you have one)

Please Supply us with your mobile telephone number *

As per Government Guidelines the most important symptoms of coronavirus (COVID-19) are recent onset of any of the following: a new continuous cough, a high temperature, difficulty breathing, a loss of, or change in, your normal sense of taste or smell (anosmia)

Have you, or anyone you live with experienced any of the above symptoms in the last 14 days? *

Yes

Are you or anyone you live with awaiting a result on a test on Covid 19? *

Yes

Have you or anyone you live with tested positive for Covid 19 in the last 14 days? *

Yes

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