COVID-19 CLIENT QUESTIONAIRE
Due to the global pandemic of COVID-19, these questions must be answered by all clients within 24 hours of their service day/time.

COVID-19 Questionaire

Due to the global pandemic of COVID - 19, these questions must be answered by all clients within 24 hours of their service. If you have not filled out this form, you will be turned away.

Have you or anyone in your home had any contact with any individual that has tested positive for COVID-19?
Are you or anyone in your house sick at this time?
Do you have a cough or runny nose?
Have you had a fever or shortness of breath?
Have you travelled domestically or internationally by commercial airline, bus, boat, or train in the last 14 days?
Have you been in close contact with anyone with these symptoms or anyone who has been diagnosed with COVID-19 in the past 14 days?

Your Signature

Azura' Studio, 856 NW Bond Street

 Bend Oregon

©2017 BY RGHAIRDESIGN