covid-19

Due to the 2019-2020 outbreak of the novel Coronavirus, Covid-19, Kamila Beauty Studio is taking extra precautions with the intake of each client, health history review, as well as sanitation and disinfecting practices. Please complete the following and sign below.

Symptoms of Covid-19 include:
• Fever
• Fatigue
• Dry cough
• Difficulty breathing
• Loss of sense of taste or smell
• Sore throat
• Runny nose

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I understand the above symptoms and affirm that I, as well as all household members, donot currently have, nor have experienced the symptoms listed above within the last 14 days.

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I affirm that I, as well as all household members, have not been diagnosed with COVID-19 within the last 30 days. I affirm that I, as well as all household members, have not knowingly been exposed to anyone diagnosed with COVID-19 within last 30 days. I affirm that I, as well as all household members, have not traveled outside of the country, or to any city outside of our own that is or has been considered as a “hot spot” for COVID-19 infections within the last 30 days. I understand that this business and my esthetician 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.

By signing below I agree to each above statement and release Kamila Beauty Studio from any and all liability for the unintentional exposure or harm due to COVID-19.
Kamila Beauty Studio agree that they abide by these same standards and affirm the same. Kamila Beauty Studio affirm that has improved and expanded sanitation and disinfection
protocols to more thoroughly fight the spread of COVID-19 and other communicable conditions.

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Date *

Date

Name *

First Name Last Name

Email *

example@example.com

Phone Number *

Area Code Phone Number

Precautionary Coronavirus Liability Release Form