Consent for salon services during COVID-19 Pandemic
Glam It Up Mobile Salon, LLC
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example@example.com
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I understand that the novel coronavirus causes the disease known as COVID-19. I understand the novel coronavirus has a long incubation period during which the carriers of the virus may not show not show the symptoms and may still be contagious. I understand that : physical distancing of 1.5 metres may not be possible while in the salon receiving services. I must sanitise my hands before entering the salon I must make all attempts to cover my mouth and nose in the event of coughing and/or sneezing and then immediately sterilse my hands I will minimise the touching of common surface/areas I may be unable to proceed with services at Jo's Xquisite Beauty if they are deemed unsafe to myself or a staff member I may NOT bring children or anyone else who does not have an appointment into the salon. I understand the staff of Jo's X-quisite Beauty will do everything possible to minimise the spread of COVID-19, but will not hold them responsible should I contract COVID-19. I confirm that: I am not currently positive for COVID-19 I am not waiting for the results of a laboratory test for COVID-19 I have not returned to Queensland from any other State or Country, whether by car, air, sea, bus or train in the past 14 days I have not been identified as a contact of someone who has test positive for COVID-19 or been asked to self-isolate by any government agency. I am not in high risk category for increased illness or death from COVID-19, including : diabetes, cardiovascular disease, hypertension, lung disease including moderate to severe asthma, being immunocompromised (including transplant recipient), having active malignancy or over the age of 65. I am NOT presenting with any of the following symptoms of COVID-19: - Fever > 38C, or 100F, chills or body aches - Cough - Sore Throat - Shortness of breath / Difficulty breathing - Flu-like symptoms - Runny Nose - Loss of smell or taste I will immediately notify the salon if I contract the virus within two weeks following my visit. By signing below, I verify that the information I have provided on this form is truthful and accurate.
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