Statement of Health
To finalize your appointment confirmation, please complete this Statement of Health. Must be completed within 24 hours of receiving request.
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I,________ , have not been quarantined within the last 14 days due to COVID-19 symptoms or illness, and I am not showing symptoms today. (Type your First and Last Name) *
Additionally, Please read and confirm the following statements prior to the start of your service: *
Required
Read and confirm the following statements prior to the start of your service: *
Required
Read and confirm the following statements prior to the start of your service: *
Required
Rad and confirm the following statements prior to the start of your service: *
Required
Read and confirm the following statements prior to the start of your service: *
Required
Today's Date *
MM
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DD
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YYYY
Signature (sign by typing out your full name in between forward slashes), as so; /First Last/   If you are a guardian signing for a child type child's name, your relationship and add your signature in the same way, as so;Child's Name, Mother, /First Last/ *
eMail
Date of Service *
MM
/
DD
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YYYY
Stylist *
Arrival Time:
Time
:
I understand that the new COVID-19 protocols come with a signification cost increase to the salon. In order for the salon to open, a new Sanitation Fee, due directly to the salon, will temporarily be $2. I understand the mask rule and I will arrive with a mask or ask to wear a washed reusable mask or purchase a medical single use mask for $2. I understand mask availability is limited and I understand that if the salon is out of masks that I will have to reschedule if I do not have one on with me. *
Required
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