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Please fill out the declaration prior to your booked appointment and take the time to

read through the Salon Protocols prior to your visit to the salon

Thank you

Covid-19 Health Declaration

This must be completed prior to your appointment at Elaine's Beauty

First Name

Last Name

Address

Email

I have NOT tested positive for COVID19 or been in contact with someone who has tested positive

I am not experiencing the symptoms: fever, cough, sore throat, body aches, shortness of breathe, loss of taste or smell, runny nose or headaches. (This refers to new or unusual symptoms not aligned with medical history, i.e. history of migraine or allergies)

I have not travelled outside Ireland (includes Northern Ireland) in the past 14 Days

Initials

Date

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!

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