Covid-19 appointment screening form

IMPORTANT INFORMATION - please read carefully before filling out

I will be taking your temperature upon arival, therefore I recommend all my clients take their temperature at home the morning of their appointment. If you have a fever I can't tattoo you that day. So it's better to know if you have a fever before you take the time to travel all the way here to see me!

An N95 Mask will be worn by both myself and all clients for the entirety of appointments (Not provided). Food and drink are not permitted, other than water, please bring your own water bottle.

If you are feeling ill at all, or have had any close contact with someone who is ill or has tested positive, please reschedule. I'd much rather everyone stay safe!
All deposits will be honoured.

After your appointment if you find out you are a close contact, or become ill, please contact me immediately at 4169092813

Thank you! - Ashley

Name:*

First NameLast Name

Have you or someone you are in close contact with tested positive for COVID-19 in the last 14 days?*

YesNo

Are you experiencing any one or more of the following symptoms. Please check all that apply:*

If you checked any of the boxes above, please explain below: (ie runny stuffy nose due to allergies)

Have you travelled outside of Canada in the last 14 days?*

YesNo

Please verify that you are human*

Signature:*

Date:*

Once signed and dated click SUBMIT below!

Appointment Screening Form