Covid-19 Nail Salon Services Consent Form

Client Name

First NameLast Name

By checking the boxes, you confirm that you agree with the following statements:

I understand that I have a risk of contracting virus during the service.I agree to obey the rules of the salon during my appointment in order to minimize the spread of viruses.I confirm that I have not been diagnosed with COVID-19 last 14 days.I verify that I am not waiting for the laboratory test results for COVID-19.I acknowledge that the nail salon, nail technician, and the other employees are licensed professionals and should be treated with respect all the time.I understand that I need to fill up a separate form related to the COVID-19 safety precautions.I confirm that the nail salon and the nail technician will not be responsible or liable if the result of the service is not as expected as it should be.I am allowing the nail salon and the nail technician to apply necessary chemicals as part of the service in my nail treatment.I agree that the nail service is final after the service. If there are any changes after 1 hour when the service ends, the client will be charged.I have read this whole document and I accept the terms indicated above.

Do you have any of these symptoms? - cough, shortness of breath, high fever, muscle pain, body ache, nausea, loss of taste/smell

YesNo

Within 14 days, have you been in contact with anyone that has COVID-19 symptoms or get infected?

YesNo

Are you living with anyone that is get infected or quarantined due to COVID-19?

YesNo

I agree not to visit the salon for any of the services provided if I have the symptoms of COVID-19. I acknowledge that the information I have given in this consent form is accurate and complete. By signing below, I confirm that I understand and agree to all terms and statements in this form.

By signing below, you confirm that you have provided accurate and current information on this form. I affirm that I have made this consent and waiver voluntarily. In any case that I decide to withdraw or revoke my waiver, I may do do by submitting a written request signed by me to the salon company.

Client's Signature

First NameLast Name

Date

Client/Parent/Guardian Signature