COVID-19 Liability Release Waiver

**Signature and Information Required Prior to Every Scheduled Appointment**

Due to the 2019-2020 outbreak of the Coronavirus (COVID-19), ESBeauty is taking extra precautions with the care of every guest to include a health history review and enhanced sanitation/disinfection procedures in accordance with the Government guidelines.

I agree to the following:*

I understand the above symptoms and confirm 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 confirm that I, as well as all household members, have NOT been diagnosed with COVID-19 WITHIN THE PAST 14 DAYS.

I confirm that I, as well as all household members, have not knowingly been exposed to anyone diagnosed with COVID-19 WITHIN THE PAST 14 DAYS.

I confirm that I, as well as all household members, have not traveled outside of the country, or to any city considered to be a "hot spot" for COVID-19 infections WITHIN THE PAST 14 DAYS.

I waive all liability of ESBeauty if I contract COVID-19.

I understand that due to the frequency of visits of other clients, the characteristics of the virus, and the characteristics of beauty services, that I have elevated the risk of contracting the virus by being in a public setting, such as this salon and accept that risk.

I understand the COVID-19 virus has a long incubation period, during which carriers of the virus may not show any symptoms and still be highly contagious. It is impossible to fully determine who is positive and who is not, given the current limits of screening in salon and I accept the risk.

Have you had a fever in the last 7 days?*

Yes

Do you, or have you recently had, a new persistent dry cough?*

Yes

Have you been in contact with anyone in the last 14 days who has been diagnosed with COVID-19 or has coronavirus-type symptoms?*

Yes

Have you been told to stay at home, self-isolate or self-quarantine?*

Yes

Do you have any other symptoms that may mean you have a COVID-19 infection?(loss of taste and smell, tiredness or shortness of breath)*

Yes

Are you pregnant?*

Yes

If your answer is yes to any of these questions, you unfortunately won’t be able to attend your appointment. This is as a result of the Government guidelines that are currently in place.

With regards to pregnancy, unfortunately my insurance during Covid-19 will not cover me to do any treatments during pregnancy sorry for any inconvenience.

ESBeauty is following these enhanced procedures to prevent the spread of COVID-19:

Additional time included between appointments to sanitize service areas and to minimize guest contact.
Increased distance between clients to adhere to safe social distancing guidelines.
No visitors during your service.
Each guest is required to wash or sanatize hands upon arrival.
Your service provider will thoroughly wash and sanitize hands as often as possible
Removal of shoes before entering salon and placed in basket by front door
Everyone in the space must be masked. Guests receiving services must wear a mask or face shield that covers the nose and mouth completely.
All surfaces will be wiped thoroughly with hospital grade disinfectant before and after each client.

By signing below, I agree to each statement above and release from any and all liability for the unintentional exposure or harm due to COVID-19. ESBeauty agrees to abide by these standards and affirms the same.

First Name

Last Name

Email Address

Mobile Number

Date*

Select Date ×

Please Sign Below

I confirm all of the above information to be true and agree to all terms and guidelines as listed above, and my agreement is in alternate of my signature.

Covid-19 Liability Release Waiver Form

COVID-19 Liability Release Waiver

Please Sign Below

Your form has been submitted