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CLIENT HEALTH QUESTIONNAIRE
CLIENT HEALTH QUESTIONNAIRE
PRIOR TO THE START OF MY SERVICE, I CONFIRM THAT:
I have not been diagnosed with or cared for someone diagnosed with COVID-19 in the past two weeks.
I have not shown symptoms of COVID-19 or come in close contact with anyone exhibiting these symptoms in the past two weeks.
I have not traveled outside of my immediate daily routine for the past two weeks.
I do not have a cough, fever, chills, shortness of breath, or loss of taste or smell.
If I begin to show symptoms of COVID-19 within the next two weeks, I will contact my stylist.
I will follow all posted salon rules to keep myself, my stylist and those around me safe.
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Printed Name:
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CLIENT HEALTH QUESTIONNAIRE
Please find the attached CLIENT HEALTH QUESTIONNAIRE in the PDF format for
Ma Belle
.