COVID Questionnaire - Beato Salon

COVID Health Questionnaire

PRIOR TO THE START OF MY SERVICE, I CONFIRM THAT: *

I have not been diagnosed with or cared for someone diagnosed with COVID-19 in the past two weeks.

I have not shown symptoms of COVID-19 or come in close contact with anyone exhibiting these symptoms in the past two weeks.

I have not traveled outside of my immediate daily routine for the past two weeks.

I do not have a cough, fever, chills, shortness of breath, or loss of taste or smell.

If I begin to show symptoms of COVID-19 within the next two weeks, I will contact my stylist.

I will follow all posted salon rules to keep myself, my stylist and those around me safe.

You MUST CHECK ALL BOXES truthfully to the best of your knowledge to begin services.

Full Name Signature *

By adding your name you are signing and attesting to the truth and accuracy of your answers to this questionnaire.

Date *

Phone *

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