Client Health Assessment Questions
I ask that you please be honest for your own safety and for the safety of others. These questions may be reiterated upon your arrival.
1. Do you now have, or have you had over the past 14 days, any COVID-19
-Cough -Loss of taste or smell
-Shortness of breath -Body aches
-Sore throat -Nausea
-Nasal congestion/runny nose -Vomiting
-Diarrhea -Fever or chills
Yes _____ No ____
If Yes, only come to the salon after a 14-day quarantine.
2. Have you had a diagnostic test for COVID 19 in the past 14 days?
Yes _____ Date of test: ________________
Results: Positive _____ Negative ______ Not Yet Received _____
If you have had a test, but the results have not yet been received, do not come to
salon until negative results are received.
If positive, even if not showing symptoms, only come to the salon after a 14 day
quarantine and subsequent test with negative results
3. Have you had close contact with anyone who has tested positive for COVID-19
or has exhibited any of the above symptoms in the last 14 days:
Yes ____ No _____
If yes, only come to the salon after 14-day quarantine, even if not exhibiting
PLEASE REPLY WITH YOUR ANSWERS TO THE TEXT MESSAGE THAT WAS SENT
Please be honest with the answers to the questions.