I Say Yes Salon & Spa COVID-19 Pandemic Consent Form for HairCare/SkinCare/Makeup
By submitting the form below you agree to knowingly and willingly consenting to have Haircare/Skincare/Makeup service during the COVID-19 Pandemic. We reserve the right to refuse service if this form is not submitted.
Email address *
Full Legal Name - Please write out name how it is spelled on your License, ID, or Passport *
Phone Number *
Have you received a positive COVID-19 test result in the past 14 days? *
Do you have any signs and symptoms of COVID-19? This includes fever or chills, shortness of breath, continuous cough, fatigue, headache, sore throat or muscles, body aches, congestion, runny nose, vomiting, diarrhea, or loss of sense of smell or taste? *
Do you live in a household with anyone who may have come in contact with a person who has experienced signs/symptoms OR received a positive COVID-19 test? *
Have you recently traveled to any region experiencing a high amount of COVID-19 cases - within the past 14 days? *
Have you recently been tested for COVID-19 - within the past 14 days? *
What was your results if you answered "Yes" to the last question?
Clear selection
Have you EVER been diagnosed with COVID-19? If "Yes", please specify exactly when. *
By clicking "Yes" below I attest that my answers above are accurate to the best of my knowledge. *
Required
By clicking "Yes" below I affirm that I will notify I Say Yes Salon & Spa if there are any changes to my responses after completing this form, and before I arrive for my appointment. *
Required
By clicking "Yes" below I affirm that I will follow all current state, and CDC guidelines while at my appointment. *
Required
You can always learn more about COVID-19 and the current guidelines by visiting CDC.gov
A copy of your responses will be emailed to the address you provided.
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