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COVID-19 Screening Questions in attempt to maintain the health and safety of FAB guests and professionals.  

May 28, 2020

In an attempt to prevent possible speading of COVID-19, we ask that you complete this waiver before entering FAB.  If your answer to any of these questions would be "Do Not Agree" please contact your service provider to reschedule your appointment to a later date.  

 

I have not experienced any of the COVID-19 symptoms (i.e., fever, cough, or shortness of breath) in the last 14 days. 

I Agree

I have not been in contact with anyone experiencing COVID-19 symptoms (i.e., fever, cough, or shortness of breath) in the last 14 days. 

I Agree

If I have traveled outside the state of Montana within the past 14 days, I will wear a mask . 

I Agree

If I have not traveled...I understand it is still advised to wear a mask when practical. 

I Agree

I will wait in my car upon arrival to FAB until my service provider texts or calls me to say their previous client has left and that their workspace is sanitary and ready for me to enter. 

I Agree

I will wash my hands or use hand sanitizer as I enter FAB. 

I Agree

I understand that salons are still required to encourage distancing as much as possible, which means anyone who is not having a treatment is not advised to come in and wait. 

I Agree

I understand that magainzes and self-serving beverages will not be available, and will bring my own if I choose to. 

I Agree

If signing this waiver in advance, I will contact my service provider if I experience a change in feeling symptoms or having exposure to anyone with symptoms, before my scheduled appointment. 

I Agree

 

 

 

 

 

First Clients Name

First Name*

Last Name*

Phone*
First Clients Date of Birth*
First Clients Signature*
Second Clients Name

First Name*

Last Name*
Second Clients Date of Birth*
Third Clients Name

First Name*

Last Name*
Third Clients Date of Birth*
Fourth Clients Name

First Name*

Last Name*
Fourth Clients Date of Birth*
Fifth Clients Name

First Name*

Last Name*
Fifth Clients Date of Birth*
Sixth Clients Name

First Name*

Last Name*
Sixth Clients Date of Birth*
Seventh Clients Name

First Name*

Last Name*
Seventh Clients Date of Birth*
Eighth Clients Name

First Name*

Last Name*
Eighth Clients Date of Birth*
Ninth Clients Name

First Name*

Last Name*
Ninth Clients Date of Birth*
Tenth Clients Name

First Name*

Last Name*
Tenth Clients Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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