- I understand the above symptoms and affirm that I, as well as all household members, do not currently have, nor have experienced the symptoms listed above within the last 14 days.
- I affirm that I am not waiting for test results from being tested for Covid-19.
- I affirm that I, as well as household members, have not been diagnosed with Covid-19 within the last 30 days.
- I affirm that as well as household members, I have not been knowingly exposed to anyone diagnosed with Covid-19 within the last 30 days.
- I affirm that I, as well as household members, have not traveled outside of the country, or any other state that is considered a "hot spot" for Covid-19 infections within the last 30 days.
- I understand that Graceful Escapes and Miranda Goan can not be held liable for any exposure to the virus or any other contagion caused by misinformation on this form or the health history provided by each client.
By signing below I agree to each above statement and release your esthetician and Graceful Escapes from any and all liability for the unintentional exposure or harm due to Covid-19.
I, Miranda Goan, abide by these same standards and affirm the same. I also affirm that I have improved and expanded my sanitation protocols to more thoroughly fight the spread of Covid-19 and other communicable conditions.