Solstice Body & Esthetics By Tiara COVID-19 Consent Form
Name
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First Name
Last Name
Phone Number
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Area Code
Phone Number
Email
example@example.com
Date
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Month
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Day
Year
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Name of Esthetician for upcoming visit and services
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Please Select
Tiara Washington
I knowingly and willingly consent to having esthetic and (or) body contouring service(s) during the COVID-19 pandemic at Solstice Body & Esthetics By Tiara at my own risk.
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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 spa's strict guidelines. I will wear approved masks and or face coverings at all times until services are started, and I am told it can be taken off. I will sanitize my hands during point of entry. I will maintain six (6) feet distances.
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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 contagious. It is impossible to determine who has it, and who does not. I understand that Solstice Body & Esthetics By Tiara is doing everything in their power to determine healthy patrons prior to entry of the spa.
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by checking this box I understand and accept this statement.
Have you been around anyone in the last 14 days that has tested positive for COVID-19
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YES
NO
I am at 18 years of age or older, and of the legal age limit. I have filled out this consent form in it's entirety and to the best of my ability
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YES
NO
In-Spa Temperature Policy
I’m willing to take a temperature check during my visit to the spa before the services are started, and I agree not to come to the spa with the following symptoms of COVID-19 listed below: Fever- Temperature, shortness of breath, loss of sense of taste or smell, dry cough, runny nose or sore throat.
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 Solstice Body & Esthetics By Tiara.
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Yes
Signature
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