Ink Is Art Tattoo Lounge
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Covid Pre-screening
If you are human, leave this field blank.
Due To COVID we are requesting that this form be submitted within 24 hours prior to your visit to the studio. if you are getting a procedure done please visit www.inkisart.ca/waiver and fill out that form instead
We request if you are feeling unwell - even if you think it might just be a cold- to please reschedule your tattoo apt. For the safety of our artists, staff and others who may be attending our facility.
Name
*
Date of your visiting the Studio
*
Email
*
Phone
*
Do you live or work in an area that is currently locked down? Grey Zone?
yes -if you are coming from an area that is currently in lock down/grey zone unfortunately we are not allowing visitors from these areas into our studio - we appreciate your understanding - we can reschedule once the lock downs have been lifted. thank you
no
Have you been in close contact with someone who is confirmed COVID-19 or probable (symptoms+ exposure) in the past 14 days without wearing appropriate PPE
*
yes
no
Have you returned from any travel outside Ontario in the last 14 days
*
yes
no
Please check off any symptoms that apply to you
*
Do you have any of the following new or worsening symptoms? Symptoms should not be chronic or related to other known causes or conditions.
Fever
Sore throat, trouble swallowing
Cough
Not feeling well
Difficulty breathing
Loss of taste or smell
Nausea, vomiting or diarrhea
Runny nose unrelated to pre-existing condition (e.g. allergies)
none of the above
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