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Before We Begin...
Thank you for filling out the following form
before
your appointment at Abelia Salon.
The questions here are mandated to be submitted 24hrs ahead of time and will be held for 60 days as per Oregons new standard. Thank you for your cooperation!
COVID Screening
First name
Last name
Email
Phone
I agree to bring and wear a mask
I agree to wait outside until previous client has left & am invited in
I (Yes or No) have at least TWO of these symptoms: Shortness of breath, Fever, Chills, Repeated shaking with chills, Muscle pain, Headache, Sore throat, New loss of taste or smell, Vomiting, Diarrhea
*
Yes
No
I (Yes, have or No, have not) come into close contact (within 6 feet) with someone who has a laboratory confirmed COVID – 19 diagnosis in the past 14 days?
*
Yes
No
I have had a fever (100.4 and up) in the last 2 days
*
Yes
No
I acknowledge I am not currently waiting for my test results of a recent COVID 19 test. (If you are waiting for test results, we will absolutely reschedule your appointment for a later date).
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