COVID-19 Informed Consent Form

Two-Ten Salon is always committed to providing stellar service as well as a safe atmosphere for its clients, and especially during the current COVID-19 pandemic. To that end, Two-Ten Salon is rigorously complying with all Centers for Disease Control (CDC) recommended guidelines for Stylist(s), staff, and facility health and cleanliness, as well as following applicable mandates of the local, State, and Federal authorities and protocol, including, but not limited to, North Carolina Executive Order 141.

To help ensure your protection, along with the protection of our Stylist(s) and other clients, the following verifications are required before we can perform the service(s) you have scheduled for your appointment.

COVID-19 Consent Form

What’s your first + last name?

Appointment Date

I, the undersigned client, consent to have my Stylist and/or his/her associates or staff (hereinafter, collectively “Stylist”) perform any of the services offered by their business, whether regarded as elective or aesthetic, during the time of the COVID-19 pandemic and after. I understand that having any services offered by my Stylist performed at this time, despite my own efforts and those of my Stylist, may increase the risk of my exposure to COVID-19. I am aware that exposure to COVID-19 can result in severe illness, intensive therapies, extended intubation and/or ventilator support, life-altering changes to my health, and even death.

I have informed my Stylist of any COVID-19 testing I or any person living with me during the past 14 days has received, as well as the results of that testing, and if I am tested between now and the date of my procedure, I will immediately provide the results of that testing to my Stylist.