Health Declaration

As part of the new Health & Safety protocols, a questionnaire is to be completed by all clients 24 hours BEFORE you come into the Salon for your treatment. This is to ensure we protect both our clients and staff as far as we possibly can.

It is imperative that you answer the questionnaire accurately. Failure to submit your health questionnaire will sadly mean you cannot attend your appointment.

Name*
First Last
Date of appointment*
Date Format: MM slash DD slash YYYY
Email*
Phone*
As per Government Guidelines the most important symptoms of coronavirus (COVID-19) are recent onset of any of the following - Have you or has anyone you live with experienced any of the symptoms listed ( in the last 14 days )
- a new continuous cough
- a high temperature
- difficulty breathing
- a loss of, or change in, your normal sense of taste or smell (anosmia)
- awaiting a result on a test on COVID-19
- tested positive for COVID-19 (in the last 14 days)
- have been asked to self-isolate by NHS track & trace
If the answer to any of the above is yes, you MUST seek medical advice and not attend any appointment.
Consent
In signing this questionnaire, I confirm that the information provided is true to the best of my knowledge and current condition. I agree to advise if my situation changes prior to or during my appointment so it can be re-arranged.