zoie rose

Name *

First Name

Last Name

Have you or someone in your household traveled out of state in the last 14 days? *

If you answer yes, expect me to reschedule you.

Yes

No

Have you experienced any COVID related symptoms in the last 14 days? *

Coughing, fever, shortness of breath or difficulty breathing Or at least two of the following: chills, repeated shaking with chills, muscle pain, sore throat, new loss of taste or smell

Yes

No

Have you been in contact with anyone who has tested positive for COVID-19 in the last 14 days? *

Yes

No

Have you been tested for COVID-19? *

Test not required for appointment, just a precautionary question. If your results are pending, expect me to reschedule you.

Yes

No

Yes- Results pending

I agree to observe the regulations posted, (verbally or written) by Iron&Rose Studio as directed by my stylist following CDC and the CA Board of Cosmetology recommendations for the health and safety of myself, as well as my stylist and anyone she comes in contact with. *

(I, Zoie Rose am doing my part, but ya'll gotta follow the rules to, ya hear?)

I agree

I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by attending Iron&Rose Studio. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any illness I may experience in attendance to Iron&Rose Studio. *

(I, Zoie Rose, pinky promise I am doing my part to prevent this, but I cannot vouch for my clients' and must take this precaution. I still trust and love you all.)

I agree