COVID 19 Pandemic Hair Treatment Consent

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Welcome back, welcome back! Every client will be charged a $5 COVID FEE!! Please complete and submit the form. Your temperature will be taken on the day of your appointment. Please call when you arrive.

Email *

Name *

I understand the COVID 19 virus has a long incubation period which carries of the virus may not show symptoms and still be highly contagious. It is impossible to determine who has it and who does not, given the current limits in the virus testing. Initial below: *

I confirm that I am not presenting any of the following symptoms of COVID 19 listed below. Initial below: *

1. Have shortness of breath? *

Yes

2. Loss of sense of taste or smell? *

Yes

3. Dry cough? *

Yes

4. Runny Nose *

Yes

5. Sore Throat? *

Yes

6. Fever-Temperature? *

Yes

I will follow the salons strict protocol and guidelines to protect others and the spread of contagious viruses. Initial below: *

I must abide by the 6 feet distance rule. Initial below: *

I verify I have not traveled outside the U. S. in the past 14 days to countries that have been affected by COVID 19. Initial below: *

I verify that I have not domestically within the U.S. by commercial airlines, buses, or trains within the past 14 days. Initial below: *

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