CLIENT CHECK IN

CLIENT CHECK IN

Covid-19 Liability waiver
NO MASK, NO ENTRY, NO APPOINTMENT!

You are visiting Born 2B Natural Salon at your own will and release Born 2B Natural Salon LLC., its service providers and patrons of any liability due to illness. Including Covid-19/Coronavirus or any strand it may carry.
WELCOME BACK,
Name

First NameLast Name
Have you experienced any COVID-19 symptoms within the last 14 days? ( Ex: Fever, cough, shortness of breath, loss of smell/taste)*

YESNO
Have you been in contact with anyone with COVID-19 within the last 14 days?*

YESNO
Does your job require you to be in contact with COVID patients?*

YESNO
If you answered yes to any previous questions, please explain.
If you are not a nurse, please cancel your appointment immediately!
Have you traveled on a plane, bus, or train within the last 14 days*

YESNO
Are you willing to wear a face mask correctly during the entirety of your appointment?*

YESNO
Do you understand that if you cough more than 2x during your appointment, your service will stop IMMEDIATELY and you will be asked to reschedule after 14 days have passed?*

YESNO
Do you understand that you CANNOT bring anyone to your appointment? ( If your child is getting serviced, parents/guardians must wait in car)*

YESNO
Refusal to fill out or sign means you are forfeiting your service and as a result any and all fees associated with your appointment will still be due as well as implementation of cancellation/ no show policy.*

Yes, I confirm all of the above to be true and will adhere to salon rulesNo, I would like to cancel my appointment
Signature of acknowledgement*

Clear
Should be Empty:

CLIENT CHECK IN

WELCOME BACK,