Appointment Check-In

We’ve stepped into a new world…where things may look different but our commitment to taking care of you hasn’t changed.

However, HOW you visit Eyrebrushed for your appointment has changed. You MUST:

ONLY FILL IN THIS FORM IF YOU HAVE A CONFIRMED APPPOINMENT

IF YOU NEED TO BOOK AN APPOINTMENT: CLICK / TAP HERE

COVID-19 SELF-DECLARATION

In consideration of the health and safety of Eyrebrushed employees and their families we ask you to please complete the below questions before you enter the premises. If you have answered yes to any of the questions below you may not be granted access to the clinic.

**Please note: this form is required to be filled out on the day of and prior to your appointment at Eyrebrushed. Forms filled in more than 4 hours ahead of your appointment are not valid.

Are you experiencing any of the following symptoms?
The protection of our staff and clients is of paramount importance. If you respond ‘YES’ to any of the above you will not be allowed to enter. We sincerely hope you understand our position.

By clicking ‘Submit’ I confirm my answers above are true & valid as of TODAY. Submitting this form acts as a signature & date to your COVID-19 Self Declaration.

*Please only tap SUBMIT once. Once form has be successfully submitted this page will refresh with a confirmation message.