COVID-19 Pandemic Tattoo Consent Form
Name
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First Name
Last Name
Date
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I knowingly and willingly consent to having tattoo service(s) during the COVID-19 pandemic.
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by checking this box I understand and accept this statement.
To prevent the spread of contagious viruses and to help protect each other, I understand that i will have to follow the tattoo shops strict guidelines
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by checking this box I understand and accept this statement.
I understand that air travel significantly increases my risk of contracting and transmitting the COVID-19 virus. I know that the CDC and OSHA recommend social distancing of at least 6 feet.
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by checking this box 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 tattoo services, that I have elevated the risk of contracting the virus by merely being in the salon company.
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by checking this box I understand and accept this statement.
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 give the current limits in virus testing.
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by checking this box I understand and accept this statement.
I verify that I have not traveled outside the United States In the past 14 days to countries that have been affected by COVID-19
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YES
NO
I confirm that I have or have not traveled domestically within the United States by commercial airline, bus or train within the past 14 days
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YES
NO
Candy Shoppe LLC
by signing this agreement, I acknowledge that contagious nature of covid 19 and volitarily assume the risk that I many be exposed to or infected by covid 19 by entering Candy Shoppe, LLC and that such exposure or infection may result in personal injury, illness, permanent disability and death. I understand that the risk of becoming exposed to or infect by COVID 19 may result from the actions, omission, or negligence of myself and other, including but not limited to Raven study LLC employees
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 Candy Shoppe LLC
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Yes
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