New Client Registration Form
  • ELITE BODY STUDIO

    ELITE BODY STUDIO

    New Client Treatment Consent Form
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  • QUESTIONS

  • Do you live an active lifestyle?*
  • Have you ever undergone plastic surgery? If yes, please specify when and where.*

  • Have you ever had the treatment you are scheduling for? If yes, please specify.*

  • Which treatment(s) are you interested in:*

  • Service preference:*
  • Do you allow Elite Body Studio to take pictures/videos during your session for social media purposes?

  • POLICIES

    Please read through carefully as exceptions will not be made if the following policies are breached. This is to ensure the safety of me and my clients and that our time will not be wasted.

  • I consent to taking photographs for progress charting and to be used on social media. Photographs will remain at Elite Body Studio at all times, and although may be posted, faces will not be shown.*
  • I am over the age of 18.*
  • I have read over the policies on instagram under the 'POLICIES' bubble. (IF NOT, PLEASE GO BACK AND READ)

  • By signing below, I verify that I have read and understood all statements and agree to them.

  • Date Signed*
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  • COVID-19 Information 

     

    COVID-19 is a highly contagious virus that spreads from person to person. In addition to long-held and explicit sanitation measures this businesses has always adhered to, new preventive measures have been put in place to further reduce the spread of this novel coronavirus. However, these best practices still offer no guarantee regarding your potential risk of being infected.

  • Have you had a fever in the last 24 hrs of 100ºF or above?*
  • Do you now, or have you recently had any respiratory or flu symptoms, sore throat, or shortness of breath?*
  • Have you been in contact with anyone in the last 14 days that has been diagnosed with COVID-19 or has coronavirus type symptoms?*

  • Authorization 

  • Authorization 


  • I understand that the novel Coronavirus (COVID-19) has been declared a global pandemic by the World Health Organization (WHO). I further understand that COVID-19 is extremely contagious and may be contracted from various sources. I understand COVID-19 has a long incubation period during which carriers of the virus may not show symptoms and still be contagious.
I understand that I am the decision maker for my health care. To the best of their ability, my practitioner will provide me wiht information to assist me in making informed choices. This process is often referred to as "informed consent" and involves my understanding and agreement regarding recommended care, and the benefits and risks associated with the provision of health care during a pandemic. Given the current limitations of COVID-19 virus testing, I understand determining who is infected with COVID-19 is exceptionally difficult.
 I understand that, because esthetics involves maintained touch and close physical proximity over an extended period of time, there may be an elevated risk of disease transmission, including COVID-19. 
By signing this form, I acknowledge that I am aware of the risks involved from receiving treatment at this time, I voluntarily agree to assume those risks, and I release and hold harmless the practitioner/business from any claims related thereto. I give my consent to receive treatment from this practitioner.


    By signing below, I verify that I have read and understood the above statements and agree to them.

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