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Covid-19 Health Declaration

How are you feeling today?

First Name

Last Name

Email

I have not traveled out of state in the last 14 days

My body temperature is lower than 98.6°F/ 37.5°C

I am wearing a mask for my services today

I am not experiencing any sickness, including fever, cough, or shortness of breath

I haven’t been in close contact with a Covid-19 positive person, or suspected positive person, in the last 14 days

I understand while Brow Chica LLC is following ALL state mandates regarding sanitation and cleanliness that there is still reasonable risk associated with receiving services today

Initials

Date

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

Thank you for your business. We appreciate your efforts to keep our salon safe & open!

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Eyebrow, Eyebrow Waxing, Waxing Service

The Esthetics District LLC. DBA: Brow Chica Brow Bar. All rights reserved 2022.
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