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CV-19 Safe Salon Client Revisit Form
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Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Do you have any of the following symptoms present today: Fever, Shortness of Breath, Runny Nose, Loss of sense of taste or smell, Dry Cough, Sore Throat, Chills, Shaking with Chills, Muscle Pain, Head Ache
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Yes
No
Have you been in contact with anyone that has been diagnosed with the COVID-19 virus during the time between this service visit and my previous service visit?
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No, I have not
Yes, I have
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