Elle Marie Spa: Covid-19 Salon Services Consent Form

Covid-19 Salon Services Consent Form

By signing this form, you agree to have hair, skin, or body services during the pandemic.
Client Name

First Name Last Name
Do you have any of these symptoms? - cough, shortness of breath, high fever, muscle pain, body ache, nausea, loss of taste/smell

Yes No
Within 14 days, have you been in contact with anyone that has COVID-19 symptoms or get infected?

Yes No
Are you living with anyone that is get infected or quarantined due to COVID-19?

Yes No
I agree not to visit the salon for any of the services provided if I have the symptoms of COVID-19. I acknowledge that the information I have given in this consent form is accurate and complete. By signing below , I confirm that I understand and agree to all terms and statements in this form.
Parent/Guardian Name (if applicable)

First Name Last Name
Date

Month Day Year
Date
Client/Parent/Guardian Signature

Clear
Should be Empty: