Covid-19 Consent Waiver
Covid-19 Pandemic Salon/Spa Treatment Consent Form. Please complete and submit this form before your scheduled appointment.
By signing your name you consent to knowingly and willingly have service during the Covid-19 pandemic.
First Name
Last Name
Email
example@example.com
I understand that due to the frequency of visits of other clients, the characteristics of the virus, and the characteristics of lash services, that I have an elevated risk of contracting the virus simply by being in the salon.
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Initial
I confirm that I am not presenting any of the following symptoms of Covid-19: temperature above 100 degrees, shortness of breath, loss of sense of taste or smell, dry cough or sore throat.
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Initial
I confirm that if I present symptoms between now and my appointment that I will cancel. I also understand that I can be denied service if I show up with symptoms.
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Initial
I confirm that I have not been around anyone with these symptoms in the past 14 days.
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Initial
I understand that the CDC, OSHA and Washington State Board of Cosmetology recommend social distancing of at least 6 feet.
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Initial
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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Initial
To prevent the spread of contagious viruses and to help protect each other, I understand that I will have to follow the salons strict guidelines upon my appointment.
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Initial
I confirm that Lionheart Lashes is released from any liability related to Covid-19.
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Initial
Todays date, confirming you have read and answered the above truthfully
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Confirm
Should be Empty: