COVID-19 Consent and Waiver of Liability
INFINITY Laser Hair Removal complies with all applicable CDC sanitation guidelines. Despite these precautions, due to the unique nature of the COVID-19 novel coronavirus pandemic, no social interaction that results in your presence in our office can be guaranteed to be completely free from risk of transmission. I acknowledge the above and consent to the risk of potential coronavirus/COVID-19 exposure, illness, and even death. I understand such exposure could occur before, during, or after my visit. I further agree to hold INFINITY Laser Hair Removal, their employees, and affiliates harmless regarding all coronavirus/COVID-19 related claims. This hold harmless shall extend to all my heirs, executors, assigns, administrations, and/or personal representatives. I voluntarily wish to proceed with my appointment and I was offered the opportunity to cancel my visit if I felt I was putting anyone at risk. My questions have been answered to my satisfaction.
- Have you been in close contact with anyone that has been diagnosed with COVID-19 in the last 14 days? Yes__ No__
- Do you have, or have you recently had, a fever, cough, chills, shortness of breath, sore throat, or muscle aches? Yes__ No__
Do you have any reason to believe you may be carrying the COVID-19 coronavirus? Yes__No__ - Have you recently returned from a COVID-19 hot spot? Yes__ No__
This client below was screened and assessed as being in the Known/Unknown risk category. Infinity Staff Initials: _____/______
Client Signature: __________________________________________________________
Printed Name: _______________________________________Date:_____/_____/_____
