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COVID-19 Salon Services Consent Form <br />Name <br />Date E-mail: <br />Initials <br />I understand that I have a risk of contracting the virus during the <br />service. <br />I agree to obey the rules of the salon during my appointment in <br />order to minimize the spread of viruses. <br />Have you experienced a fever greater that 100 degrees F in <br />the last 24 hours? <br />Have you experienced any vomiting or diarrhea in the last 24 <br />hours? <br />Have you been diagnosed with any contagious medical <br />conditions in the 14 days? <br />Have you experienced any shortness of breath in the last 14 <br />days? <br />Have you travelled domestically or internationally to any <br />area with an outbreak of COVID-19 in the last 14 days? <br />Have you or anyone inside your home been exposed to an <br />individual with a confirmed COVID-19 diagnoses? <br />Client Signature <br />Technician Signature <br />i <br />Date <br />