COVID Health Questionnaire
Name *
Have you been confirmed positive for COVID-19, or has anyone within your household? *
If yes, how long ago?
Do you have any symptoms of COVID-19? For example, a fever, cough, or shortness of breath? *
Have you knowingly been in contact with any person who has COVID-19? *
Have you been in contact with anyone who has travelled recently? If yes, please wait until they receive their test results before attending your appointment . *
Have you, yourself travelled off island recently ? If yes - please wait until your test results are returned before your appointment. *
Thank you!
If at any time you have been confirmed as positive for COVID-19 please inform us via phone or email, especially if you have attended the salon in the last fourteen days.

Thank you for your time and patience.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy