Virtual Waiting Room

433 Grand Canyon Drive, Madison, WI 53719

(608) 662 9010

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Keeping our employees and clients safe is our number one priority at Duncan Edward.

The Coronavirus COVID-19 has been declared a Worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local
governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people along with adding new safety recommendations.

While we have always taken your safety and that of our employees very seriously, we are implementing more stringent safety,

By filling out this agreement, you acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that you may be exposed to or infected by COVID-19.

Polling Form (#2)

Full Name

Phone

By checking the boxes below, you are confirming NO on each statement.

Have you had any type of cough in the last 14 days?

Yes

Have you had a fever (higher than 100 degrees) in the last 14 days?

Yes

Are you living/lived with anyone who is/has been quarantined due to Covid-19 in the last 14 days?

Yes

Have you been around anyone showing symptoms of Covid-19 in the last 14 days?

Yes

By checking the boxes below, you are confirming yes on each statement.

I acknowledge that I am free to go to other salons who may not require my agreement to accept responsibility for contracting COVID-19 and I chose of my own free will to have hair, color, and facial waxing.

I understand the risk of becoming exposed to or infected by COVID-19. I hereby release, covenant not to sue, discharge, and hold harmless Duncan Edward European Hair Design its employees, clients, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto.

433 Grand Canyon Drive, Madison, WI 53719 | (608) 662 9010 | contact@duncanedward.com