COVID-19 Consent Form

Name *

First Name Last Name

Date *

Month Day Year

Name of therapist for upcoming visit *

Name of stylists *

First Name

I knowingly and willingly give my consent to receive a facial or massage treatment(s) during the COVID-19 pandemic. *

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 Sheer Bliss' guidelines. I must enter Sheer Bliss with a face cover, practice social distancing and reschedule my appointment if I'm feel ill. *

by checking this box I understand and accept this statement.

I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be expose to or infected by COVID-19 during my spa visit. I understand that the risk of becoming exposed to or infected by COVID-19 during my spa visit may result to illness and accept sole responsibility for any illness to myself. I hereby release, covenant never to sue, discharge, and hold harmless to Sheer Bliss and their employees of and from any claims, including all liabilities of any kind. *

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 never 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. *

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. I confirm that I have not traveled within the United States by commercial flights in the past 14 days that have been highly affected. *

YES NO

Have you or anyone in your household been tested for COVID-19 in the past 14 days? *

YES NO

I understand, read, and completed this consent form 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 Sheer Bliss Organic Spa *

Yes

Signature *

Clear

COVID-19 Sheer Bliss Consent Form