MYPERFECTBROWS

COVID 19 QUESTIONNAIRE / GENERAL LIABILITY WAIVER FORM

To ensure the safety of all guests and our team.
THIS FORM MUST BE COMPLETED PRIOR TO SERVICE

WALK IN CLIENTS ARE REQUIRED BY STATE LAW TO WAIT IN THEIR CAR OR AT A SAFE DISTANCE FROM OTHER GUESTS, WHILE WAITING TO BE CALLED FOR SERVICES. *MASKS ARE REQUIRED FOR ENTRY **MASK IS AVAILABLE AT NO CHARGE IF NEEDED
THIS FORM SERVES AS A WAIVER

FOR WAXING, LASH LIFT, BROW HENNA, BROW LAMINATION, EYELASH EXTENSION AND FACIALS. CLIENTS: PLEASE READ OUR COMPLETE WAIVER FORMS AND TERMS AND CONDITIONS (push back button) FOR SERVICES YOU REQUEST BEFORE SIGNING. https://myperfectbrows.com/covid-19-updates
Name *

First Name Last Name
Phone Number *
Email *
example@example.com
Date of Service(s)
Preferred studio *

CITY OF ORANGE (3130 E. Chapman Ave) LONG BEACH (203 Argonne Ave) SAN JUAN CAPISTRANO (27221 Ortega Hwy) LOS ANGELES (5115 Wilshire Blvd)
Select service(s) below. *

Threading (Any) *Face Wax (any region) *Lip Wax *Full Body Wax *Brazilian Wax *Arm Wax *Leg Wax *Wax (other) *Lash Lift *Lash Extensions *Henna Brows / Tinting *Brow Lamination *Microblading *Facial Services
CHOOSE A LOCATION BELOW

Because of capacity limits and to ensure the safety of all guests we are inviting you to reserve a 30 min window for your appointment.
ORANGE LOCATION Preferred 30 minute window time slot.
LONG BEACH LOCATION Preferred 30 minute time slot.
SAN JUAN CAPISTRANO LOCATION Preferred 30 minute time slot.
LOS ANGELES LOCATION Preferred 30 minute time slot.
WE ARE DOING OUR PART TO HELP STOP THE SPREAD OF THIS VIRUS. WE FOLLOW ALL RECOMENDATIONS AND ADHERE TO ALL STANDARDS AND GUIDELINES PROVIDED BY THE STATE OF CALIFORNIA.

WE ENCOURGE YOU TO WASH YOUR HANDS BEFORE AND AFTER YOUR VISIT.
Are you experiencing any of the following symptoms? *

FEVER COUGH SHORTNESS OF BREATH CHEST OR BODY PAINS NONE
In the last 21 days have you been in contact, infected, suspected, or diagnosed with Covid-19? *

YES NO
Parent/Guardian Name (if applicable)

First Name Last Name
Client or Parent (Guardian) Signature *

Clear
BY HITTING SUBMIT I AGREE TO ALL TERMS AND CONDITIONS

FULL WAIVER TERMS AND CONDITIONS CAN BE SEEN BY HITTING THE BACK BUTTON ON YOUR BROWSER NOW or by CLICKING the “terms&conditions link above. .
PROMO CODE (if applicable)
Should be Empty:

COVID 19 QUESTIONNAIRE / GENERAL LIABILITY WAIVER FORM

THIS FORM MUST BE COMPLETED PRIOR TO SERVICE

THIS FORM SERVES AS A WAIVER

CHOOSE A LOCATION BELOW

BY HITTING SUBMIT I AGREE TO ALL TERMS AND CONDITIONS