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Covid-19 Informed Consent
Please fill out the following covid-19 declaration form in order to participate in our activity.
First Name
Last Name
Phone
INFORMED CONSENT COVID-19 PANDAMIC
I understand that I have entered into this premise because I am opting for a service that is not urgent and not medically necessary. I also understand that the coronavirus disease (COVID-19) has been declared a worldwide pandemic by the World Health Organization. I further understand COVID-19 is extremely contagious. State and federal health agencies recommend social distancing. I recognize that the staff at Style Nails Andover are closely monitoring this situation and have put in place reasonable preventive measures targeted to reduce the spread of this virus. However, given the nature of the virus, I understand there is still an inherent risk of becoming infected with COVID-19 if I enter into this premise and/or proceed with this elective service. Accordingly, I acknowledge and assume the risk of becoming infected with COVID-19, and any variation of mutation thereof, during the time of my stay in this premise and/or through this elective service and I gave my express permission for the staff at Style Nails Andover to proceed with the same. This consent applies to any follow up or additional services being provided at Style Nails Andover I understand that even if one has been tested for COVID-19 and received a negative test result, the tests may not have detected the virus or he or she may have contracted COVID-19 after the test. I also understand that I may contract COVID-19 from anyone within or outside this premise without knowing it. I therefore will not hold this business and professional offering the service responsible for any liability related to COVID-19 and any variation or mutation thereof. I understand that exposure to COVID-19 before, during, or after my procedure(s) may result in complications and/or delayed healing. I have been given the option to defer my service to a later date, However, I understand all the risks including those noted herein and I would like to proceed with this service.
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I confirm that i understand the explanation and consent to the procedure
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