Covid-19 Consent Form
By submitting this form, you agree to have nail and skin services during the pandemic.
Client Name
*
First Name
Last Name
By checking the boxes, you confirm that you agree with the following statements:
*
I understand that I have a risk of contracting virus during the service.
I agree to obey the rules of the salon during my appointment in order to minimize the spread of viruses.
I confirm that I have not been diagnosed with COVID-19 last 14 days.
I verify that I am not waiting for the laboratory test results for COVID-19.
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.
Date
*
-
Month
-
Day
Year
Date
Client Signature
*
Submit
Should be Empty: