Due to the 2020 outbreak of the novel Coronavirus, COVID 19, Relaxology Spa is 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.
Symptoms of Covid 19 include: • Fever • Fatigue • Dry Cough • Difficulty Breathing
I agree to the following: I understand the above symptoms and affirm 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 affirm that I, as well as all household members, have not been diagnosed with Covid 19 within the last 30 days. I affirm that I, as well as all household members, have not knowingly been exposed to anyone diagnosed with Covid-19 within the last 30 days. I affirm that I, as well as all household members, have not traveled outside of the Country within the last 30 days. I understand that Relaxology Spa, and its employees, cannot be held liable for any exposure to the virus or any other contagion caused by misinformation on this form or the health history provided by each client.
I agree to each above statement and release Relaxology Spa and its employees from any and all liability for the unintentional exposure or harm due to Covid-19 and other communicable conditions.
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