Share Your Story to Support Keeping Salons Open

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* 1. What is your full name?

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* 2. What is your email address?

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* 3. What is your industry role?*

Owner/manager: Employee based salon

Owner/manager: All stylists are independent contractors

Owner/manager: Hybrid booth rental/Employee based salon

Hair stylist: Employee based salon

Hair stylist: Booth renter in salon or salon suite

Barber

Esthetician

Makeup artist

Massage therapist

Nail tech

Retired

Unlicensed employee in salon environment

Other (please specify)

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* 4. What is the name of your salon? This information will be kept private and will not be shared.

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* 5. State and Zip

State/Province

ZIP/Postal Code

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* 6. How many licensed professionals work in the establishment?

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* 7. How many clients have received services at your salon establishment since reopening from state mandated closures?

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* 8. How many of your clients received a COVID-19 positive test within 14 days of visiting your salon?

Zero

More than 5

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* 9. How many people were possibly exposed to COVID-19 in your salon?

Zero

More than 5

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* 10. How many confirmed secondary cases of COVID-19 can be traced back to your salon?

Zero

More than 5

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* 11. Are you willing to share your story as it pertains to the coronavirus pandemic (how you and your salon have been affected)? If you agree to share your story we will not share any personal information including the name of your salon.

Yes

If "Yes" please share your story below

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* 12. Please share what safety protocols you have in place.

Masks required of employees

Masks required of clients

Hand sanitizer provided

Wearing disposable gloves

Physical separation between stations

Sanitizing between clients

Other (please specify)