Capital Waxing Salon | Nail salon 20036 | Skin Care Washington DC 20036

I understand the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious. It is impossible to determine who has it and who does not, given the current limits in virus testing. *

Yes

No

I confirm that I am not presenting any of the following symptoms of COVID-19 listed below. *

• Temperature above 98.7 degrees (Given that we are entering summer, you may wait in the lobby for 5-10 minutes to cool down and we will retake your temperature)
• Shortness of breath
• Loss of sense of taste or smell
• Dry cough
• Sore Throat

Yes

No

I confirm that I have not been around anyone with these symptoms in the past 14 days. *

Yes

No

I do not live with anyone who is sick or quarantined. *

Yes

No

To prevent the spread of contagious viruses and to help protect each other, I understand that I will have to follow the salon’s strict guidelines. *

Yes

No

I understand that air travel significantly increases my risk of contracting and transmitting the COVID-19 virus. And I understand that the CDC, OSHA and DC Board of Cosmetology and Barbers recommend social distancing of at least 6 feet. *

Yes

No

I verify that I have not traveled outside the United States in the past 14 days to countries that have been affected by Covid-19. *

Yes

No

I verify that I have not traveled domestically within the United States by commercial airline, bus, or train within the past 14 days. *

Yes

No

Digital Signature. *

Clear

Capital Waxing Salon | Nail salon 20036 | Skin Care Washington DC 20036

Consent

Covid-19 Pandemic Waxing/ Hair/ Nail/ SkinTreatment Consent Form

Only fill out this form before arriving. Please take a moment to complete our consent form.