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COVID-19 Form
COVID-19 Questionare for clients
Dear Client
As you are scheduled for an appointment at CreateInk Tattoo Studio we require you to please fill in and submit this form.
During the COVID-19 pandemic I am taking additional steps to make sure everyone can stay healthy and safe when you come in for your tattoo.
It is very important that you inform me in advance if anyone in your household is unwell, or self-isolating with COVID-19.
Unfortunately, due to strict public health requirements I will be unable perform services if anyone in your household is unwell or in self-isolation. I will of course treat this information in strict confidence and will be happy to reschedule your appointment for another time.
What CreateInk Tattoo Studio is doing
You might also like to know about the measures that I have put in place to manage the
risks
of exposure to COVID-19 when you come in for your appointment
.
These include increased hygiene measures, physical distancing when not operating, the wearing of personal protection equipment like masks and gloves and the sterilisation of all equipment used.
What you can do
It is important to me to be able to continue to provide my regular service to you at this time.
Please help me to manage the
risks
to the health and safety of our staff by cooperating with the measures I have outlined above and by wearing a mask to your appointment. Do the same things for me that you are doing to keep your own family and friends healthy and well.
This includes frequent hand-washing and covering your nose and mouth with a mask when you visit the studio. More information can be found on the Department of Health website:
https://www.health.gov.au/
If you have any queries or concerns please feel free to contact me directly.
Kind regards
Liezel
Please fill in the questions below:
*
Indicates required field
Name
*
First
Last
Have you travelled abroad during 2020?
*
Yes
No
Have you been in contract with people infected, suspected or diagnosed with COVID-19?
*
Yes
No
If yes, your relationship with the person/Persons and the last contact date with them
*
Please state whether you have experienced/are experiencing any of the following:
*
Fever
Cough
Shortness of breath
Persistent pain in chest
Loss of smell
I acknowledge that the information I have given is accurate and complete
Submit
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COVID-19 Form