COVID-19 Screening Checklist

For all of our safety, please fill this out 24 hours prior to your appointment (until further notice). Be sure that the information you’ll give is accurate and complete. Please get immediate medical attention if you have any of the severe COVID-19 signs.

In the past 14 days, I have experienced...

"IF YES to any of the questions above please call us immediately and cancel your appointment."
"IF No to all proceed with remaining statements."

If you answered NO to all questions you will be allowed entry to building.
Please be aware of the following protocols:
  • You will immediately wash your hands for at least 20 seconds upon entry into the building.
  • Not to shake hands with, touch or hug others during your time in the building.
  • Not congregate in any space within the salon & spa.

  • By signing the form bellow I am acknowledging the potential risk to contract the COVID 19 disease during serviecs provided today and voluntarily agreed to accept services. You further agree and hereby release My Spa Rituals & Esthetics and employees from any and all liabilities with your potential risk to contact Novel Corona virus (COVID-19).

    *The person answering YES to any of the above questions is responsible for following up with their primary care physician if needed.

    Due to Covid-19 Safety procedures, all clients need to fill this mandatory safety form before they receive a service from us. Click Here to Go to form