GG BODY BAR APPOINTMENT

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Our reservation fee is $150 and will go to your services afterwards. Is it ok with you? *

Yes

Are you currently taking medications, had recent surgery for the past 6 months? *

Yes

Do you currently suffer from any chronic disease? (High blood, Diabetes, others) *

Yes

기타:

Do you have any of the following respiratory condition? (Cough or Shortness of breath) *

Yes

Have you had a (temperature 100.4*F or greater within the past 14 days?) *

Yes

Have you been in a facility or home with confirmed COVID-19 by lab test within the last 14 days? *

Yes

Have you been with persons with confirmed COVID-19 by lab test within the last 14 days? *

Yes

What is your preferred time and date of appointment? *

YYYY

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