COVID-19 Pandemic Hair and Makeup Consent Form

Please take a moment to complete our consent form.
By submitting the form below you agree to knowingly and willingly consenting to have hair and/or makeup service during the COVID-19 pandemic.
We reserve the right to refuse service if this form is not submitted. Thank you.
Email address *
Today's Date
I understand the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious. It is impossible to determine who has it and who does not. *
I understand that due to the frequency of visits of other clients, the characteristics of the virus, and the characteristics of hair services, that I have an elevated risk of contracting the virus simply by being in the salon. *
I confirm that I am not presenting any of the following symptoms of COVOID-19 listed: • Temperature above 98.7 degrees• Shortness of breath• Loss of sense of taste or smell• Dry cough• Sore Throat *
I confirm that I have not been around anyone with these symptoms in the past 14 days. *
I verify that I have not traveled outside the United States in the past 14 days to countries that have been affected by COVID-19. *
I verify that I have not traveled domestically within the United States by commercial airline, bus, or train within the past 14 days. * *
To prevent the spread of contagious viruses and to help protect each other, I understand that I will have to follow the salon’s strict guidelines. *
I understand that air travel significantly increases my risk of contracting and transmitting the COVID-19 virus. And I understand that the CDC and New Jersey Board of Cosmetology and Barbers recommend social distancing. *
Please type your full name below. By typing and submitting, this serves as a Digital Signature and verifies that you fully agree to our safety policy for our services. This digital signature holds the same authority as a handwritten one. Thank you. *
Rosalyn Holmes
Hair Stylist/Makeup Artist
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy