COVID-19 Pre Booking Form

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If you are considered high-risk or vulnerable to COVID-19 in accordance with World Health Organization and Centers for Disease Control and Prevention guidelines, such as those who are currently pregnant, those with chronic diseases, those with a sensitive medical situation and those over 65, and you have concerns about being in the location for service please refrain from visiting the locations at this time.

All guests are required to bring own face mask to appointment. Due to stock we cannot guarantee to always have a mask available.

Email *

First and Last Name *

Have you had any symptoms of COVID-19, including fever, cough, shortness of breath, general malaise, muscle aches, loss of sense of smell or taste, diarrhea, nausea or feel unwell or have a runny/stuffy nose, sore throat or are sneezing in the last 14 days? *

Yes

Within the past 14 days have you have been caring for, or living with, someone diagnosed with COVID-19 or symptoms of COVID-19. *

Yes

Within the past 14 days have you been advised to home quarantine because of an exposure to COVID-19. *

Yes

Send me a copy of my responses.

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