COVID-19 Pandemic Hair Treatment Consent Form
Name
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First Name
Last Name
Today’s Date
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Month
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Day
Year
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Phone Number
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Area Code
Phone Number
Name of Stylist for upcoming visit
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Please Select
Bri
I knowingly and willingly consent to having hair service(s) performed during the COVID-19 pandemic.
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by checking this box I understand and accept this statement.
I will come alone to my appointment. If I am accompanied by another person, they must also have an appointment with Bri Boss Hair and will wait in the car until their scheduled appointment time.
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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 AND wear a mask for the entire duration of my service.
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by checking this box I understand and accept this statement.
I understand that air travel significantly increases my risk of contracting and transmitting the COVID-19 virus. I know that the CDC, OSHA, and California state board of cosmetology recommend social distancing of at least 6 feet.
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by checking this box I understand and accept this statement.
I understand the COVID-19 virus has a long incubation period during which carriers 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 virus testing.
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by checking this box I understand and accept this statement.
I verify that I have NOT traveled outside the United States in the past 14 days to countries that have been affected by COVID-19.
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YES
NO
I confirm that I have NOT traveled domestically within the United States by commercial airline, bus or train within the past 14 days.
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YES
NO
In-salon Temperature Policy
I’m willing to take have my temperature taken (using a touch less digital forehead thermometer) upon my arrival to the salon before any services begin. I agree not to come to the salon with the following symptoms of COVID-19 listed below: Fever/High Temperature, chills, muscle pain, shortness of breath, loss of taste/smell, dry cough, runny nose, sore throat, etc.
I understand, read, 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 Bri Boss Hair in her salon.
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Yes
Signature
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