NOVA Salons
Customer and Staff questionnaire
Date
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
In the past 14 days have you had a cough?
*
yes
no
In the past 14 days have you had a fever?
*
yes
no
Have you been around anyone exhibiting these systems within the past 14 days?
*
yes
no
Are you living with anyone who is sick or quarantined?
*
yes
no
Client/employee temperature:
*
If temperature if over 99 degrees client/employee must be sent home. Governor's instructions.
Submit
Thank you for choosing Cool Beauty! Where your success is cool!!
coolbeautyconsulting.com
Should be Empty: