I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing. I further acknowledge that Brown Psychological Services has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19. I further acknowledge that Brown Psychological Services can not guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to staff, and other patients and their families.I voluntarily seek services provided by Brown Psychological Services and acknowledge that I may be increasing my risk to exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending my appointment. I hereby release and agree to hold Brown Psychological Services harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of the office, or that may otherwise arise in any way in connection with any services received from Brown Psychological Services. I understand that this release discharges Brown Psychological Services from any liability or claim that I, my heirs, or any personal representatives may have against the office with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from Brown Psychological Service. This liability waiver and release extends to all offices at 748 Morris Turnpike Suite 207 together with all owners and employees. *
