Health Declaration

Please fill out the following form
to insure your booking is secured.

First Name

Last Name

Prior to my self-care service with Salon 6, I affirm that I DO NOT have symptoms similar tothat fond t exist with COVID-19 ie; Required

Common Cold: runny nose, stuffy nose, fever, chills etc.

Symptoms commonly experienced with allergies: sinuys drainage, swollen throat, itchy watery eyes, etc.

Symptoms commonly associated with the Flu: Sore muscles, fatigue, body aches, exhaustion, etc.

Symptoms attributed to the stomach flu: Sore stomach, vomiting, diarhea, etc.

Symptoms caused by airborne or person-to-person contagions.

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

I understand the requirement of wearing my mask is optional, and my stylist may wear theirs. I also understand I will be asked to reschedule at any sign of illness recognized by my stylist.

Initials

Thanks for submitting!

SALON 6 SPA & WELLNESS

320 W MAIN ST IONIA 48846
616.522.9870

Health Declaration

SALON 6 SPA & WELLNESS

320 W MAIN ST IONIA 48846 616.522.9870

Health Declaration

320 W MAIN ST IONIA 48846
616.522.9870