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COVID-19 Prescreening Questionnaire

1. I hereby confirm that I, as well as all members of my household, HAVE NOT EXPERIENCED any known COVID-19 symptoms within the last 14 days.
2. I confirm that I, as well as all members of my household, HAVE NOT BEEN DIAGNOSED with COVID-19 within the last 14 days.
3. I confirm that I, as well as all members of my household, HAVE NOT BEEN KNOWINGLY EXPOSED to anyone diagnosed with COVID-19 in the last 14 days.
4. I confirm that I HAVE NOT TRAVELLED out of the country within the last 14 days.
5. If anything changes from now until my appointment, I will notify Linna’s Beauty Studio as soon as possible.
6. I understand the potential health risks associated with unintentional exposure to the COVID-19 virus. I agree to release this facility and it’s staff from all liability concerning my possible exposure and health risks associated with COVID-19 that I may encounter due to my procedure.

 Thanks for submitting!