Name *

First Name

Last Name

Phone *

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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 and who does not, given the current limits in virus testing. *

Yes

I understand that due to the frequency of visits of 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 studio. *

Yes

I confirm that I am not presenting any of the following symptoms of COVOID-19 listed below: * • Temperature above 98.7 degrees • Shortness of breath • Loss of sense of taste or smell • Dry cough • Sore Throat *

Yes

I confirm that I have not been around anyone with these symptoms in the past 14 days. *

Yes

I do not live with anyone who is sick or quarantined. *

Yes, I do not live with anyone who is sick or quarantined.

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

Yes

I understand that I may be unable to proceed with services at Sucré Studio if i am deemed unsafe to myself or anyone affiliated with Sucré Studio. *

Yes

I understand that Sucré Studio will do everything possible to minimize the spread of COVID – 19, but will not hold them responsible should I contract the COVID – 19. *

Yes

I will immediately notify Sucré Studio if I contract the virus within two weeks following my visit. *

Yes

I verify that the information I have provided on this form is truthful and accurate. *

Yes

Date *

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DD

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