Eyelash Extension Service Consent Form for COVID-19 

 

Due to the 2019-2020 outbreak of the novel Coronavirus, COVID-19, we are taking extra precautions with the intake of each client, health history review, as well as sanitation and disinfecting practices. Please complete the following and sign below. 

 

I, _______________________________, confirm that I am not presenting any of the following symptoms of COVID-19 listed below:

 

Fever, shortness of breath, loss of taste or smell, dry cough, runny nose, sore throat

 

I agree with the following:

• I understand the above symptoms and affirm that I, as well as household members, do not currently have, nor have experienced the symptoms listed above within the last 14 days

• I affirm that I, as well as household members, have not been diagnosed with COVID-19 within the last 30 days

• I understand that the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms & still be highly contagious

• I understand that due to the frequency of visits of other clients, the characteristics of the virus, and the characteristics of these services that I have an elevated risk of contracting the virus simply by being in the establishment

• To prevent the spread of the contagious virus and to help protect each other, I understand that I must follow the establishment’s guidelines

 

• Wear a mask 24/7 which requires upon arrival of the appointment, during the procedure, and exiting the establishment 

• Rescheduling the appointment when you are developing any symptoms and overall are feeling unwell

• No additional guest is allowed into the building

• Wash hands upon arrival and will be asked to wash hands before the procedure 

• Limit conversation during the procedure

 

Under these circumstances, there will be no exceptions. As a home-based business, I am is here to protect you and yourself if anything were to arise. Any rules that are broken and mistreated, ELLE M LASHCO will deny you coming into the building and will ask you to reschedule

 

I, knowingly and willingly consent to have eyelash extension service during the pandemic and will not hold ELLE M LASHCO or anyone working for this establishment, liable for the possibility of contracting COVID-19