COVID-19 ID Cosmetic Clinic Screening Questions

Instructions

Please complete this form on the day of your appointment, print it andbring it to your appointment.

If your answer is Yes to questions 2, 3 or 4, or if you have any of the symptomslisted in question 1, please reschedule your appointment for a day when

you are symptom-free and can answer No to questions 2, 3 and 4.