Healthy Nails and Spa COVID-19 Pandemic Nails Treatment Consent Form

Name *

First Name Last Name

Phone Number *

Area Code Phone Number

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Your appointment Date and Time *

<----- click here for create the DATE

Time Slot Hour Minutes AM/PM Option

How many people for this appointment ? *

I, (type your name)* , knowingly and willingly consent to have nail treatment during the COVID-19 pandemic at Healthy Nails and Spa.

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 the salon responsible if I were to contract COVID-19 infection around and during the time of services. *

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 the salon. *

I understand and accept this statement.

Do you have any following symptoms? *

Yes

No

Fever

Shortness of Breath

Loss of sense of taste or smell

Dry cough

Runny nose

Sore throat

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. Require to wear a mask at all time. *

I understand and accept this statement.

I understand that air travel significantly increases my risk of contracting and transmitting the COVID-19 virus. And I understand that the CDC, OSHA and OHA recommend social distancing of at least 6 feet. *

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? *

Yes No

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

Yes No

I understand, read, 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 Healthy Nails and Spa. *

I agree

Date *

Signature *

Clear

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COVID-19 Pandemic Nail Treatment Consent Form