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Evie Johnson
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Welcome
CLASSES
Upcoming Classes
About
Evie Johnson
EJ Portfolio
Salon Services
Consultation
Store
Contact
COVID-19 PANDEMIC HAIR TREATMENT CONSENT FORM
I knowingly and willingly consent to having hair and salon service(s) during the COVID-19 pandemic.
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By checking this box I understand and accept this statement.
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. *
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By checking this box I understand and accept this statement.
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 elevated the risk of contracting the virus by merely being in the salon company. *
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By checking this box I understand and accept this statement.
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 give the current limits in virus testing. *
By checking this box I understand and accept this statement.
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 give the current limits in virus testing. *
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By checking this box I understand and accept this statement.
I understand that air travel significantly increases my risk of contracting and transmitting the COVID-19 virus. I know that the CDC, OSHA, and the Maryland state board of cosmetology recommend social distancing of at least 6 feet.*
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By checking this box I understand and accept this statement.
I confirm that I am not presenting any of the following symptoms of COVID-19, temperature above 100.4 degrees; shortness of breath; loss of sense of taste or smell; dry cough; sore throat. YOUR TEMPERATURE WILL BE CHECKED UPON ENTRY.
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By checking this box I understand and accept this statement.
I do not live with anyone who is sick or quarantined.
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By checking this box I understand and accept this statement.
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.
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YES
NO
I confirm that I have not traveled domestically within the United States by commercial airline, bus or train within the past 14 days*
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YES
NO
I acknowledge that the stylists and all employees of E and E Hair Solutions agree to abide by these same standards and affirm the same. We also affirm that we have improved and expanded our sanitation protocols to more thoroughly prevent the spread of COVID-19 and other communicable conditions. For the time being all clients will be asked to wear a mask at all times and asked to wash their hands prior to the start of their service. I also understand and acknowledge that a $20 COVID fee will be added to my final bill.
I understand, read, and completed this questionnaire truthfully. I agree that this constitutes full disclosure and that it supersedes any previous verbal or written disclosures. I understand that this document is to provide the best possible guest experience when visiting the salon
YES
WAIVER AND RELEASE
I hereby waive all claims and forever release the E and E Hair Solutions , including its officers, directors, employees, successors, assigns, agents, heirs, representatives, and volunteers as applicable, in their individual or corporate capacities, of all claims, liabilities, agreements, and causes of action of any nature due to any injury, loss, or damage to person or property, that may arise out of my services performed at the Salon. By electronically signing below, I agree to the above statements and release E and E Hair Solutions, Evie Johnson, its officers, staff and practitioners from any and all liability for the unintentional exposure or harm due to COVID-19.
Signed
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Date
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ADDITIONAL GUIDELINES
The Salon and my stylists are 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 sanitize hands upon arrival. • Your service provider will thoroughly wash and sanitize hands as often as possible. • 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 and restrooms will be wiped thoroughly with hospital grade disinfectant before and after each client. • Routine temperature Checks of Staff and Clients 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. The Salon and my stylist agree to abide by these standards and affirms the same.
Signed
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Date
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Thank you!
