Oregon required COVID-19 screening

To be filled out within 24 hours of appointment

Are you exhibiting any COVID-19 related symptoms such as, but not limited to: Fever, Chills, Cough, Shortness of breath, Difficulty breathing, Fatigue, Muscle or body aches, Headache, New loss of taste or smell, Sore throat, Congestion, Runny nose, Nausea, Vomiting, Diarrhea?
Have you experienced any of these symptoms in the last 14 days?
Have you been in close contact with anyone in the last 14 days that was experiencing COVID-19 related symptoms?
Do you understand that while I am doing everything I can to ensure yours, mine and everyone else in the salon's safety, this is a new virus which we are learning new information about all the time, therefore you leave your house and enter another establishment at your own risk?

Thanks for submitting!