Coronavirus Pre Wedding Consultation

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Please ensure everyone having hair and/or make up on your wedding day completes the below consultation form. Government requirements need me to keep records in accordance with Covid-19 track and trace. This information will not be passed on to any third party other than the Government track and trace and only if a track and trace by the company is required.

Please ensure this form is received no more than 24 hours before the wedding date, failure to do so will mean the treatments cannot take place for any indivdual who has not filled it in.

Coronavirus Pre Wedding Consultation Form

First Name

Last Name

Phone

Your role in the wedding (Bride / Bridesmaid / Mother etc)

Wedding Date

Have you or anyone you are looking after or living with tested positive for Covid-19 in the last 14 days? *

Yes

Have you or any member of your household experienced any of the following in the last 14 days? *

Temperature

New or persistent or dry cough

Shortness of breath

Extreme exhaustion

Loss of taste or smell

None of the above

Have you or any member of your household been in contact with any of the following? *

Contact with someone who has or may have Coronavirus the past 14 days

Contact with someone who has been in contact with a person who has or may have Coronavirus in the past 14 days

None of the above

Have you or any member of your household returned from another country in the last 14 days *

Yes

If yes where from?

HAIR AND MAKE UP CONSULTATION FORM - Medical History *

Diabetes

Epilepsy

Recent scars on area to be treated

Recent operations on area to be treated

Allergies

None of the above

I declare that the information I have provided is accurate & complete

I have read the wedding day procedures information and agree to follow the safety guidelines in place.View Wedding Day Procedure

Your Signature

Date

Thanks for submitting!

enquiries@nicolahodgkinson.co.uk

Tel: 07921 384606

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