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Covid Screening

Due to the continued rise in COVID-19 cases and based on the CDC Guidelines, service providers are encouraged to screen all clients for signs of the novel coronavirus (COVID-19) symptoms prior to their appointment.

*If you are experiencing any of the COVID-19 symptoms listed below, please cancel your appointment immediately.

Fever Cough

Shortness of Breath

Muscle Pain

High Temperature

Bluish lips or face

Cough

Sore Throat

Fatigue

Loss of sense of smell/taste

Headache

Chills

Congestion

Runny Nose

Difficulty Breathing

Body Aches

Nausea

Vomiting

Diarrhea

Pain/Pressure in Chest

☐I confirm that I am not displaying or currently experiencing any of the COVID-19 symptoms listed above.

☐I understand that carriers of COVID-19 may not show symptoms but may still be contagious.

☐I have NOT tested positive for COVID-19 and am NOT presumptively positive for COVID-19.

☐I have NOT been in a facility or home with confirmed COVID-19 by lab test within the last 14 days.

☐I have NOT traveled outside of the state of Hawaii in the last 14 days. ☐I am NOT currently waiting to receive COVID-19 test results.

☐I confirm that I have not been in contact with persons with confirmed COVID-19 by lab test within the last 14 days.

☐I am acknowledging the potential risk to contract the COVID-19 disease during services provided today and voluntarily agree to accept services and follow all salon protocols included but not limited to:

• Sanitizing your hands upon entry

• Avoiding shaking hands and hugging others during your time in The Sustainery Hair Studio

• Maintaining social distancing and not congregating in any space within the The Sustainery Hair Studio

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By signing below, you pledge to provide only correct and truthful information when completing this screening

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Sustainery Hair Studio https://sustaineryhairstudio.com

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September 11, 2020 10:06 pm HST

Covid Screening Uploaded by Anjalee MIddleton - lanee@sustaineryhairstudio.com IP 72.253.206.158