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QUESTIONNAIRE – DAY SPA

SGA (05-07) Day Spa QUESTIONNAIRE Page 1 of 6 QUESTIONNAIRE DAY SP A Please answer all questions fully. Submit this QUESTIONNAIRE with a completed ACORD Commercial Insurance Applicant Information Section and prior carrier loss runs. Named Insured: Is the business operated as a: Salon Day spa Other: Do all professionals, and the business, have current licenses where required by statute? Yes No OPERATIONS Check all applicable items that describe services offered: Beauty/Barber Shop Manicurists Facials including peels Waxing Microdermabarasion Electrology Spray Tanning Locker Rooms Sauna Shower Rooms Steam Rooms Sun Tanning Units Whirlpool Body Wrap Other (Describe below) GENERAL INFORMATION 1.

SGA (05-07) Day Spa Questionnaire Page 1 of 6 QUESTIONNAIRE – DAY SPA Please answer all questions fully. Submit this Questionnaire with a completed ACORD Commercial Insurance Applicant Information Section and prior carrier loss runs.

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