COVID-19 Policy Procedures & Release of Liability Waiver

COVID-19 Policy Procedures & Release of Liability Waiver

**Signature Required Prior to Every Scheduled Appointment**
Amy's Healing Arts

Massage and Reiki Center
Covid-19 discription:

Symptoms may appear 2-14 days after exposure to the virus. People with these symptoms may have COVID-19:
Fever or chills
Cough
Shortness of breath or difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea
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 COVID-19 WITHIN THE PAST 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 PAST 30 DAYS. I affirm that I, as well as all household members, have not traveled outside of the country, or to any city considered to be a "hot spot" for COVID-19 infections WITHIN THE PAST 30 DAYS. I understand that Amy Mullett and Amy's Healing Arts cannot be held liable for any exposure to the COVID-19 virus caused by misinformation on this form or the health history provided by each client. I understand I will be required to wear a face mask inside the facility, refusal of a face mask will prompt immediate cancellation of appointment with the right for Amy's Healing Arts to refuse your booking of further appointments upon repeated refusal. I understand my temperature will be taken upon entering the facility. If I have a temperature or signs of symptoms my appointment will be rescheduled.
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COVID-19 Policy Procedures & Release of Liability Waiver

Amy's Healing Arts