The Healing Tree Covid 19 Release form




Precautionary Coronavirus Liability Release Form

Due to the 2019/2020 outbreak of the Coronavirus, COVID-19, we are taking extra precautions with 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

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Please fill out the form below:  I understand the above symptoms and affirm that I , as well as my household members, do not currently have, nor have experienced the symptoms listed above in the last 14 days. *
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* I affirm that I, as well as all household members, have not been diagnosed with COVID-19 within the last 30 days. *
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* I affirm that I, as well as all household members, have not traveled outside of the country, or to any city outside of our own that has been considered a "hot spot" for COVID-19 infections within the last 30 days.   *
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* I understand that this business and my practitioner 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. *
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 * I understand that I am not able to bring additional guests with me into the spa for my appointment. *
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By signing below I agree to each above statement and release Shed Skin & Massage, DBA Shed & Co., along with any independent licensees or practitioners from any liability from any unintentional exposure or harm due to COVID-19.Your practitioner and all independent licensees of this facility agree that they abide by the same standards and affirm the same. We also affirm that we have improved and expanded our sanitation protocols to more thoroughly fight the spread of COVID-19 and other communicable conditions.  By signing I am agreeing to the above information * *
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