2052 Num Num Crescent, Wilderness044 093 0930

Health Screening Questionnaire

To prevent the spread of COVID-19 and reduce the potential risk of exposure to our staff and visitors, we are conducting a simple screening questionnaire. Your participation is important to help us take precautionary measures to protect you and everyone in our salon. Thank you for your time.

    Tick if you (or your child) experience any or none of the following symptoms:
    NoneCoughFeverSore ThroatShort of breath

    Do you live with anyone or have been in contact with anyone who shows the above symptoms or is in isolation?
    NoYes