Covid 19 Questionnaire

Thank you for taking the time to read and fill out the Covid 19 Questionnaire form, please read the new Guidelines prior to filling out the questionnaire.

I knowingly and willingly consent to having beauty treatments during the COVID 19 pandemic and I am aware that during the treatment social distancing cannot be maintained causing an elevated risk of contracting COVID 19.

I confirm that I do not have any of the following symptoms below:

  • Fever/high temperature
  • Shortness of breath
  • Loss or change to my sense of smell or taste
  • New persistent cough

I confirm that to the best of my knowledge I have not been around anybody with these symptoms in the last 14 days.

I do not live with anyone that is in isolation or sick.

I am not classed as being in the shielded category.

I understand that I will need to follow HM Beauty's guidelines when attending my appointment to help stop the spread of COVID 19.

I confirm that I have not travelled outside the UK in the past 14 days to countries that have been effected by COVID 19.

I am aware that my information may be used for test and trace and that it will be held for 21 days and deleted if requested.

Please Tick the following to agree.



Please complete the "I'm not a Robot" Captcha and send questionnaire.