COVID-19 Pandemic Hair Treatment Consent Form
Name
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First Name
Last Name
Appointment
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Phone Number (We will be contacting you to confirm appointment)
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Area Code
Phone Number
Name of Stylist for upcoming visit
*
Please Select
Harry
Renan
Acie
Anyone
Not Sure
Name of stylists
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What services are you going to avail?
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Hair Cut
Hair Color
Hair Treatment
Rebonding
Perming
Blowout
I knowingly and willingly consent to having hair and salon service(s) during the COVID-19 pandemic.
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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
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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 hair services, that I have elevated the risk of contracting the virus by merely being in the salon company.
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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 give 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 Philippines 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 or have not traveled domestically within the Philippines by commercial airline, bus or train within the past 14 days
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YES
NO
In-salon Policy
Stated are protocols that our Salon has put in place for you, our client and our employees safety.
Just some reminders:
Please arrive 15 minutes before your scheduled appointment. We have a 10min grace period, failure to arrive on time will lead to cancellation of appointment.
Changes to time of appointment should be done a day before scheduled appointment.
I understand that my temperature will be checked before going in to the salon and if it exceeds 37.8C I will not be allowed to go inside the salon.
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Yes
I understand that I will have to wear a mask at all times and will not be allowed to go in the salon if I refuse to do so.
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Yes
I understand that I will be required to bring my own towel to be used on my hair for my own safety. Not bringing a towel will result in the use of our in-house towel at your own risk. ( We launder our towels after each client, this protocol is just another extra safety measure that we are taking for your health and safety)
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Yes
I understand that I'am not allowed to bring a companion inside the salon
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Yes
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 Kami Studio Salon
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Yes
Signature
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Submit
Should be Empty: