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;

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

318 w. main st, ionia, MI 48846

Health Declaration

*A Product Charge is in addition to Service Charges. Prices vary $0.50 - $7.00 per ounce