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COVID-19 SCREENING FORM
Full Nameyour full name
Phone Number
Have you experienced the following symptoms in the last 72 hours?
I have not been in close contact with another person who has been diagnosed with or under investigation for COVID-19 within the previous 14 days.
I acknowledge that Spa Rejuv cannot guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, salon staff, and other salon clients and their families.
I knowingly and freely assume all such risks, both known and unknown, and assume full responsibility for my participation in any service provided by Spa Rejuv.
Type Name of Client/ Legal Guardian
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