Form is successfully submitted. Thank you!CLIENT HEALTH QUESTIONAIRE AND WAIVERPlease check all that apply. If you are unable to check each box, please reschedule your appointment.*I have not been diagnosed with or cared for someone diagnosed with COVID-19 in the past two weeks.I have not shown symptoms of COVID-19 or come in close contact with anyone exhibiting these symptoms in the past two weeks.I have not traveled outside of my immediate daily routine for the past two weeks.I do not have a cough, fever, chills, shortness of breath, or loss of taste or smell.If I begin to show symptoms of COVID-19 within the next two weeks, I will contact my stylist.I will follow all posted salon rules to keep myself, my stylist and those around me safe.WAIVER*I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing. I further acknowledge that Styles Beauty Lounge has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19. I further acknowledge that Styles Beauty Lounge can not 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 voluntarily seek services provided by Styles Beauty Lounge and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending my appointment. I hereby release and agree to hold Styles Beauty Lounge harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of the salon, or that may otherwise arise in any way in connection with any services received from Styles Beauty Lounge. I understand that this release discharges Styles Beauty Lounge from any liability or claim that I, my heirs, or any personal representatives may have against the salon with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from Styles Beauty Lounge. This liability waiver and release extends to the salon together with all owners, partners, and employees.Name:*Date:*Email*Signature* Submit