COVID-19 Health Assessment  & Liability Waiver Form

To prevent the spread of Covid-19 to the Community, our Staff, and our Wellness Partners, your temperature will be taken and you will be asked to sign a Covid19 Health Assessment & Liability Waiver log confirming you have read and understood our Covid-19 policy. A hard copy will be provided to you at arrival upon request. 


BODYLINES DAY SPA, INC.
Guest COVID-19 Information & Liability Waiver

IF YOU ANSWER YES TO ANY OF THE HEALTH ASSESSMENT QUESTIONS, PLEASE RESCHEDULE!

COVID-19  Health assessment Information


 1. Have you had a fever in the last 24 hours of 100.0°F or above?

 
 2. Do you now, or have you recently had, any respiratory or flu symptoms, sore throat, or shortness of breath? 


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


COVID-19 is a highly contagious virus that spreads from person to person. In addition to long-held and explicit sanitation measures this business has always adhered to, new preventative measures have been put in place to further reduce the spread of this novel coronavirus. However, these best practices still offer no guarantee regarding your potential risk of being infected. 


Consent for Treatment I understand that, because esthetics, massage therapy, and body work involves maintained touch and close physical proximity over an extended period of time, there may be an elevated risk of disease transmission, including COVID-19. 


By signing the Covid-19 Information & Liability log, I acknowledge that I have answered “NO” to the above health assessment questions and give my consent to receive treatment(s). I understand I may ask for a copy of this form.


I am aware of the risks involved from receiving treatment at this time, I voluntarily agree to assume those risks, and I release and hold harmless the Bodylines practitioner/ Bodylines Day Spa, Inc. from any claims related thereto. I give my consent to receive treatment from this practitioner(s).

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Contact

(925) 837-8895

Address

2330 San Ramon Valley Blvd, San Ramon, CA 94583, USA

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