• The Beauty Room- Health Form

    For the health and safety of our clients and our team, declaration of illness (or lack thereof) is required prior to receiving any treatments at The Beauty Room. Be sure that the information you provide is accurate and complete.
  •  -
  • Date of treatment
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    2 digit month, 2 digit day, 4 digit year
  • Please indicate if you have experienced any of the below symptoms in the last 14 days...*
  • Has anyone in your household experienced any of the above symptoms in the last 14 days?*
  • Have you been in contact with anyone that has been confirmed as having Covid 19 in the last 14 days?*
  • Have you returned from abroad in the last 14 days?*
  • I understand the importance of notifying The Beauty Room using the below contact information if I experience any of the above symptoms up to 14 days after my treatment?*

  • If you or a member of your household experience any of the symptoms related to Covid 19 or are diagnosed with Covid 19 within 14 days of you having a treatment at The Beauty Room. Please contact The Beauty Room on 0151 345 6195 or email Thebeautyroom2020@outlook.com. We really appreciate your cooperation at this time to keep you, your family and our team safe. Thank you

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: