Precautionary Liability Release & Client Agreement:
• I acknowledge that the floatation tank contains Epsom salt (magnesium sulfate) and hydrogen peroxide, and natural enzymes which may produce an adverse reaction in certain people.
• I am choosing to use the floatation tank of my own free will and agree that I will not hold the owner/operator or Bloom Wellness for any injury or other matter occurring during or after a session while on premises. This includes slipping as a result of entering, or exiting the floatation tank. For the purposes of this agreement, Bloom Wellness means Bloom Wellness LLC, and its affiliates and their respective owners, members, employees, agents, contractors and landlords (Finkler Enterprises LLC)
• By the execution of this agreement, I accept and willingly assume full responsibility for any and all injuries including entering and exiting the facility including the parking lot, damages (both economic and non-economic), and losses of any type, which may occur to me or my guest, and I hereby fully and forever release and discharge the company, its insurers, employees, officers, directors, and associates, from any and all claims, demands, damages, rights of action, or causes of action, present or future, whether the same be known or unknown, anticipated, or unanticipated, resulting from or arising out the use proper, or improper of said equipment, and facilities.
• Due to the outbreak of the novel Coronavirus, COVID-19, we are taking extra precautions with the intake of each client, health history review, as well as sanitizing and disinfecting practices. Please complete the following and sign below.
Symptoms of COVID-19 include, but not limited to:
Fever, Fatigue, Dry Cough, Difficulty breathing, Chills, Nausea or vomiting, Diarrhea, Confusion, Muscle Pain, Headaches, Red or Purple Toes, Loss of Taste, Bruising, Cramping in Lower Legs.
• I agree to the following: I understand the above symptoms and affirm that I, as well as all household members, do not currently have, nor have experienced the symptoms listed above within the last 14 days. I affirm that I, as well as all household members, have not been diagnosed with COVID19 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 the 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 a “hot spot” for COVID-19 infections within the last 30 days. I understand that this business (Bloom Wellness LLC), landlord (Finkler Enterprises LLC) and my massage therapist cannot be held liable for any exposure to the virus or any other contagion passed on via massage therapist, employees, other customers in the space, or general shared use of the space or Equipment.
• By checking the box below, I agree to each above statement and release the massage therapist, and Bloom Wellness from any and all liability for the unintentional exposure or harm due to COVID-19. Your massage therapist and all employees of this facility agree that they abide by these same standards and affirm the same. We also affirm that we have improved and expanded our sanitization protocols to more thoroughly fight the spread of COVID-19 and other communicable conditions.
Client Agreement:
• I understand that Bloom Wellness does not diagnose illness, disease, any physical or mental disorder, nor do they prescribe medical treatment, pharmaceuticals, or perform joint mobilization.
• I acknowledge that massage therapy is not a substitute for medical examination or diagnosis, and it is recommended that a physician be seen for that service.
• I have stated my pertinent medical conditions, and will update the massage therapist of any changes in my health status.
By my electronic signature below, I agree to the Coronavirus Liability Release & Client Agreements above.