Safety & Health Survey

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This survey must be completed prior to entry into Leon Studio One School of Beauty Knowledge

Email *

Name: First & Last *

Todays Date: *

YYYY

Have you tested Positive for COVID-19 within the last 14 days? *

Yes

Have you come in close contact (i/e., within 6 feet with anyone who you know has tested positive for COVID-19 within the last 14 days? *

Yes

Have you experienced in the past 14 days: 1) Cough, shortness of breath, or difficulty breathing; OR 2) At least 2 of the following: fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell? *

Yes

If you checked Yes to experiencing symptoms in the previous question, have you experienced any of those symptoms in the last 72 hours? *

Yes

Has anyone in your household experienced in the past 72 hours: 1) Cough, shortness of breath, or difficulty breathing; OR 2) At least 2 of the following: fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell?

Yes

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Have you traveled to an non-contiguous state (Pennsylvania, Massachusetts, New Jersey, Connecticut, Vermont) in the last 14 days? *

Yes

I certify that the answers provided are true and correct to the best of my knowledge. *

Yes

Submit

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