Safety & Wellness Form - Kylie Rose Hair

First Name

Surname

Address

Country

Postcode

Your Email

Your Phone Number

Date

I knowingly and willingly consent to have hair services during the Covid-19 pandemic.

I understand the Covid-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious. It is impossible to determine who has it, given the current limits in virus testing.

I understand that due to the frequency of visits from other clients, the characteristics of the virus, and the characteristics of hair services, that I have an elevated risk of contracting the virus simply by being in the salon.

To prevent the spread of contagious viruses and to help protect each other, I understand that I will have to follow the salons strict guidelines.

I verify that I have not travelled outside the UK in the past 14 days to countries that have been affected by Covid-19, or to a UK or England Covid-19 ‘hot bed’ area.

Do you have a cough that’s lasted for an hour, or have had 3 or more episodes of coughing in 24 hours?

Do you have a fever/temperature (37.8c or greater) now or have had in the past 14-21 days?

Have you knowingly come into contact with any confirmed Covid-19 positive patients in the past 14 days?

Are you experiencing shortness of breath or any difficulty in breathing?

Are you experiencing any loss of taste or smell?

Do you have heart disease, lung disease, kidney disease, diabetes or any auto-immune disorders?

I understand that due to increased PPE requirements in the salon and all guests, along with the extra sanitation times, the salon and services will have a £10 COVID HOUSE fee applied to every service and will remain while in 50% capacity restriction phase.

I hereby acknowledge and attest that I have read, understood, and acknowledge the Kylie Rose Hair Salon COVID-19 pandemic policy presented above, and hereby confirm that the information I have provided above is fully true and accurate.