Client Health Questionnaire

Client Health Questionnaire
Name *

First Name Last Name
Have you been diagnosed with or been in contact with someone diagnosed with COVID-19 in the past 14 days? *

Yes No
Have you been experiencing any symptoms of COVID-19 that are NOT related to any other condition in the past 14 days? (cough, fever, sore throat, loss of taste/smell) *

Yes No
Have you been in close contact with anyone showing these symptoms that are NOT related to any other condition in the past 14 days? *

Yes No
If you begin to show symptoms of COVID-19 within the next 14 days, will you let us know as soon as possible? *

Yes No
What to do when you arrive:
- Check-in through the Rosy app, text, or by calling the front desk at 517-622-1770
- Wait in your car for your stylist or the front desk to call you and let you know we are ready for you.
- Come in through the front door and meet your sylist at the front desk.
- Head to the bathroom and wash your hands.
*Don't forget your mask! Your stylist will provide one for you if you don't have one*
Should be Empty: