Health Check Questionnaire

As part of our new health & safety protocols at Suzanne’s Hair & Beauty Salon in Coventry, we are asking all clients to please complete this questionnaire 24 hours prior to your hair or beauty service. We are doing this to safeguard our clients and team so please be as accurate as possible with your answers.  Thank you.

Name *

First

Last

Email *

Phone

When Is Your Appointment (date & time please)? *

HAIR: Who Are You Booked In With?

• Stacey
• Vicky
• Michelle
• Keyleigh
• Tracey

BEAUTY / NAILS: Who Are You Booked In With?

• Paula
• Lisa
• Shirley
• Gemma
• Jenna
• Karolina
• Kristy
• Sharon
• Suzanne

Please let us know if you have experienced any of the symptoms listed below by clicking on the relevant boxes. If you are feeling unwell, please cancel your appointment immediately and seek medical advice. We will reschedule your appointment once your period of isolation is over.

• A new continuous cough
• A high temperature or fever
• Difficulty breathing
• A loss of, or change in, your normal sense of taste or smell
• Are you or is anyone you live with awaiting a result on a test for COVID-19?
• Have you or has anyone you live with tested positive for COVID-19 in the last 14 days?

Comment

Submit

All information we collect from you will be held confidentially and in compliance with GDPR along with your normal consultation forms.