Client Health Questionnaire
COVID-19 Health Survey
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By checking the boxes, you confirm that you agree with the following:
I have not been diagnosed with or cared for someone diagnosed with COVID-19 in the past two week.
I have not shown any symptoms of COVID-19 or come in close contact with anyone exhibiting these symptoms in the past two weeks
I have not traveled outside of my immediate daily routine for the past two weeks
I do not have a cough, fever, chills, shortness of breath, or loss of taste or smell
If I begin to show symptoms of COVID-19 within the next two weeks, I will contact the salon immediately.
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
by checking this box I understand and accept this statement.
In-salon Symptoms Policy
I agree not to come to the salon with the following symptoms of COVID-19 listed below: Fever- Temperature Shortness of breath Loss of sense of taste or smell Dry cough Runny nose Sore throat
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 Coco Hair Design
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