COVID-19 Elegant Nails Salon Service Consent Form

Name

First NameLast Name

Phone Number

Area CodePhone Number

Time

:HourMinutesAM/PM Option

Date

I knowingly and willingly consent to have a nails, pedicure, waxing treatment during the Covid-19 pandemic.

By checking this box I understand and accept this statement.

To prevent the spread of contagious viruses and to help protect each other, I understand that I will have to follow the salon's strict guidelines. Required to wear a mask at all time.

By checking this box I understand and accept this statement.

I understand that air travel is significant increases my risk of contracting and transmitting the COVID-19 virus. I know that the CDC, OSHA and MICHIGAN STATE BOARD of cosmetology recommend social distancing of at least 6 feet.

By checking this box I understand and accept this statement.

I understand the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious. It is impossible to determine who has it, and who does not given the current limits in virus testing, therefore I will not hold ELEGANT NAILS SALON responsible if I were to contract COVID-19 infection around and during the time of services.

By checking this box I understand and accept this statement.

I understand that due to the frequency of visits of other clients, the characteristics of the virus, and the characteristics of nail, pedicure, or waxing services, that I have elevated the risk of contracting the virus by merely being in the salon.

By checking this box I understand and accept this statement.

Have you traveled outside the United States in the past 14 days to countries that have been affected by COVID-19?

YesNo

Have you traveled domestically within the United States by commercial airline, bus or train within the past 14 days?

YesNo

Have you been in contact with a person with COVID-19, in quarantine, or have symptoms of COVID-19 within the past 14 days?

YesNo

In-Salon Temperature Policy

I am willing to take a temperature check during my visit to the salon before any service started, and I agree not to come in the salon with the following symptom of COVID-19 listed below: Fever of 99 degree or higher, cough, shortness of breath, chest pain, headache, loss of sense of taste or smell, runny nose, sore throat, muscle pains, diarrhea, nausea/vomiting.

I fully read, understand and completed this questionnaire truthfully. I agree that this constitutes full disclosure and that it supersedes any previous verbal or written disclosures. I understand that this document is to provide the best possible guest experience when visiting.

Yes

Signature

ELEGANT NAILS SALON LLC.

COVID-19 NAILS SALON SERVICE CONSENT FORM