The Nitty Gritty Hair & Waxing Parlor Covid-19 Consent Form.
THE NITTY GRITTY HAIR & WAXING PALOR IS COMMITTED TO EVERYONES SAFETY.
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First Name
Last Name
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I knowingly and willingly consent to having hair and waxing service(s) during the COVID-19 pandemic and do not hold the Nitty Gritty Hair & Waxing Parlor liable for any illness that may occur.
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by checking this box I understand and accept this statement.
I understand that due to the frequency of visits of other clients, the characteristics of the virus, and the characteristics of the services I am receiving, that I have elevated the risk of contracting the virus by merely being in the The Nitty Gritty Hair & Waxing Parlor
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by checking this box I understand and accept this statement.
To prevent the spread of contagious viruses and to help protect each other, I understand that I will have to follow the salon's strict guidelines; ie washing//sanitizing hands upon arrival, wearing a mask at all times while in the salon, and entering the salon alone w no extra guest, children or family members.
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by checking this box I understand and accept this statement.
I understand that the CDC, OSHA, and New York State recommend social distancing of at least 6 feet.
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by checking this box I understand and accept this statement.
I understand by receiving services at The Nitty Gritty Hair and Waxing Parlor, I am unable to properly social distance, significantly increasing my risk of contracting the virus
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by checking this box I understand and accept this statement.
I confirm that I have not knowingly come in contact w anyone who is or has been treated for Covid-19 in the past 14 days
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YES
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I can confirm the I am not experiencing any Covid-19 symptoms such as Fever- Temperature, Shortness of Breath, Loss of Taste or Sense of Smell, Dry Cough, Runny Nose & Sore Throat .
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YES
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I read, understand, and completed this questionnaire truthfully. I agree that this constitutes full disclosure and that it supersedes any previous verbal or written disclosures. I understand that this document is to provide the best possible guest experience when visiting The Nitty Gritty Hair & Waxing Parlor
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Yes
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