Symptoms of COVID-19 include: * Nausea or vomiting
* Diarrhea * Confusion * Sore throat *Fatigue *Muscle aches
*Body aches *Headache *Loss of taste or smell
Please read ALL of the following statements carefully and initial on each line to indicate your understanding and acceptance:
I acknowledge the contagious nature of COVID-19 and that the CDC and many other public health providers still recommend practicing social distancing. I further acknowledge that my Service Provider has put in place preventative measures to prevent the spread of COVID-19
I further acknowledge that my Service Provider can not guarantee that I will not become infected with COVID-19. I understand that the risk of becoming exposed and/or infected with COVID-19, this may result from the actions, omisions and negligence of myself and others, including but not limited to salon staff, and other salon clients and thier families.
I voluntarily seek services proved by my Service Provider and acknowledge that I am increasing my risk to exposure to COVID-19 I acknowledge that I comply with all set procedures to reduce spread while attending my appointment.
I confirm that I as well as anyone in my household, have not had any of the above symptoms of COVID-19 or have not been diagnosed with COVID-19 within the last 30 days.
To the best of my knowledge, neither I nor anyone in my household have been in contact with anyone who has tested positive for COVID-19.
I confirm that neither I nor anyone in my household has traveled outside of the United States in the past 30 days.
I understand that the CDC recommends social distancing of at least 6 feet, and this is not possible with the service I am receiving today.
I understand that this business and my technician cannot be held liable for any exposure to the virus or any other contagion caused by misinformation on this form or the health history provided by each client. With mysignature below, I give consent to receive treatments and I have read and completed this questionnaire truthfully. I understand. I hereby release and agree to hold my Service Providers, who's signature is below, harmlessfrom, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property thatmay be caused by any act, or failure to act of the salon, or that may otherwise arise in any way in connection withany services received from my Service Provider. I understand that this release discharges my Service Provider from any liability or claim that I, my heirs, or any personal representatives may have against the salon with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from my Service Provider. This liability waiver and release extends to the salon together with all owners, partners, and employees.