COVID-19 Health Declaration

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How are you feeling today?

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Last Name

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My body temperature is 98.6°F/ 37.5°C or lower

I am not experiencing the symptoms: fever, cough, sore throat, loss of smell, loss of taste, nausea, vomiting, diarrhea

I haven’t been in close contact with a Covid-19 patient in the last 14 days

I nor anyone in my household has traveled out of the country in the past 14 days

I nor anyone in my household has traveled to a COVID-19 hot spot in the US in the past 14 days

I nor anyone in my household have attended an event where 10 or more people were gathered and social distancing and face covering protocols were not observed in the past 14 days

I am following the CDC guidelines to protect myself and others while out in public

I understand that while in Blown Away Salon & Hair Restoration Studios I am required to observe all safety protocols in place. I acknowledge that if I am out of compliance with any of the safety protocols, I will be required to leave immediately.

I declare that the info I’ve provided is accurate & complete

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