Name *

First Name

Last Name

Phone *

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NEW SALON HEALTH + SAFETY FORM IN RESPONSE TO COVID-19 *

PLEASE READ + MARK EACH BOX BELOW. BY SUBMITTING THIS FORM, YOU CERTIFY THAT YOU HAVE COMPLETELY READ, UNDERSTAND, AND WILL COMPLY WITH THE NEW COVID-19 PROTOCOLS. We understand that there are a lot of changes as we return to the salon and want to express our sincere gratitude for your patience and understanding during these challenging times. The health and well-being of our guests, team and community is of utmost importance to us, as is the continued ability of Art + Autonomy to remain in business and keep our doors open.

I, or anyone I am in regular close contact with, have not experienced or shown any symptoms of COVID-19 within the last 14 days prior to my appointment. Symptoms include: fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and diarrhea.

I certify that I am in compliance with NYS's travel advisory that if I travel outside NYS for more than 24 hours, I will either self quarantine for 14 days or, for anyone traveling outside NYS , you must "obtain a test within three days of departure, prior to arrival in New York. The traveler must, upon arrival in New York, quarantine for three days. On day 4 of their quarantine, the traveler must obtain another COVID test. If both tests comes back negative, the traveler may exit quarantine early upon receipt of the second negative diagnostic test."

I will wear an ear loop mask (one that ties behind the ears, not the back of the head) and sanitize my hands upon entering the salon. My mask will remain on for the duration of my visit. (If you don’t have a mask, one will be available for purchase.)

I will respect the 6-foot social distancing policy.

I understand that I will limit the personal items I bring with me to the salon knowing there is limited space to store items in a personal, sealed bin. I also understand that only cell phones and laptops may be out during my appointment.

I understand that no additional person can accompany me to my appointment. (This includes children and pets.)

I will arrive on time to my appointment. If I am late, I understand that I will likely not be able to be seen and will be charged for the full appointment.

I am aware of the salon's 24 hour cancelation policy. "We understand that life can sometimes get in the way of great hair. However, in order to provide you with the best service, we require a credit card to hold all appointments and 24 hours notice when canceling an appointment. Missed appointments or failure to notify us within the 24 hour window will be charged the full service amount. Lateness will also be charged the full amount of the service. If you arrive too late that it will impact our next guest, we cannot perform your service and you will be charged. We cannot fill your missed appointments last minute and it negatively impacts our stylists and our salon. We thank you in advance for your understanding. If there are extenuating circumstances, we will apply the charged amount to your next service if re-booked within the week."