COVID-19 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

- Sore throat, trouble swallowing

- Runny Nose/stuffy nose or nasal congestion

- Decrease or loss of smell or taste

- Pink Eye

- Headache

- Nausea, vomiting, diarrhea, stomach pain

- Not feeling well, extreme tiredness, sore muscles

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 14 days, have you been identified as a “close contact” of someone who currently has COVID-19?
4. In the last 14 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? If you are exempted from federal quarantine as per Group Exemptions, Quarantine Requirements under the Quarantine Act, select “No”