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Covid-19 Health Screening Form


All patrons must complete this form on the day of their appointment prior to entry of the Salon. Forms must be submitted no sooner than 24hrs prior to the your scheduled appointment.  

We would like to thank all of our Patrons for their continued understanding and support during these times. 

1. Are you currently experiencing any one of the symptoms below that are new or worsening? Symptoms should not be chronic or related to other known causes or conditions.

- Fever or Chills

- Cough or barking cough

- Difficulty breathing or shortness of breath

- Decrease or loss of smell or taste

- Fatigue. lethargy, malaise and/or myalgias

(If you received a COVID-19 vaccination in the last 48 hours

and are experiencing mild fatigue that only began

after vaccination, select “No.”)

2. Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)?
3. In the last 10 days, have you been identified as a “close contact” of someone who currently has COVID-19? If public health has advised you that you do not need to self-isolate (e.g., you are fully immunized* or have tested positive for COVID-19 in the last 90 days and since been cleared), select “No.”
4. In the last 10 days, have you received a COVID Alert exposure notification on your cell phone? If you already went for a test and got a negative result, select "No."
5. In the last 14 days, have you travelled outside of Canada AND been advised to quarantine (as per the federal quarantine requirements)?
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