Designer Waxing |Covid-19 Consultation Form -Designer Waxing

Full name*

Date of birth

Email address*

Have you had / suffered from or experienced any of the below Covid-19 symptoms within the last 14 days?

Fever
New/Persistent Cough
Loss of, or change in, sense of smell or taste

If the answer is yes to any of the above please contact us regarding your appointment.

Have you been diagnosed with Covid-19 in the last 8 weeks?*

Yes
No

Do you live with someone who has either tested positive for COVID-19 or had symptoms of COVID-19 in the last 14 days?

Yes
No

Have you been abroad in the last 14 days?*

Yes
No

What country?

Do you fall in the ‘governments’ high risk category?

Are over the age of 70
Have underlying health issues
Pregnant

I hereby unconditionally waive all claims, release and forever discharge Designer Waxing from all and any liability whatsoever in relation to any claim that may arise if I contract COVID-19.*

Yes
No