COVID-19Release Form At Studio She

COVID-19 Pandemic Hair Release Form at Studio She

 

I,  __________________________________________________, knowingly and willingly consent to have hair / skin/ body service during the COVID-19 pandemic. _________ I understand the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious. 

 

It is impossible to determine who has it and who does not, given the current limits in virus testing.

 

 _________ I understand that due to the frequency of visits of other clients, the characteristics of the virus, and the characteristics of hair services, that I have an elevated risk of contracting the virus simply by being in the salon. 

 

_________ I confirm that I am not presenting any of the following symptoms of COVOID-19 listed below: • Temperature above 98.7 degrees • Shortness of breath • Loss of sense of taste or smell • Dry cough • Sore Throat

 

 _________ I confirm that I have not been around anyone with these symptoms in the past 14 days. 

 

_________ I do not live with anyone who is sick or quarantined.

 

 _________ To prevent the spread of contagious viruses and to help protect each other, I understand that I will have to follow the salon’s strict guidelines.

 

 _________ I understand that air travel significantly increases my risk of contracting and transmitting the COVID-19 virus. And I understand that the CDC, OSHA and Maryland State Board required a recommended social distancing of at least 6 feet. 

 

_________ 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 verify that I have not traveled domestically within the United States by commercial airline, bus, or train within the past 14 days. 

 

Date__________________________

 

Signature______________________

Studio She Frederick, MD & Studio She Annapolis, MD

Phone:  301-378-9172

Text:  240-329-6163

e-mail:  studioshe@gmail.com