Covid19 Consent

I Willing Consent to having Service(s) Or Treatment(s) during the Covid19 pandemic.

To prevent the spread of contagious viruses and to help protect each other, I understand that I must follow the strict guidelines of the medical spa.

I understand that there is increased risk of spreading/contracting COVID-19 due to the frequency of patient visits, the requirements of medical spa services, and the characteristics of the virus itself.

I understand that without proper testing you cannot determine who has the COVID-19 virus and who doesn’t. The virus has a long incubation period during which carriers may not show symptoms, but may still be highly contagious.

Have you traveled internationally via commercial airline, bus or train within the past 14 days?

Have you traveled domestically via commercial airline, bus or train within the past 14 days?

Have you traveled I have followed the recommendations of my local health authority regarding COVID-19 rules.

I am willing to take a temperature check immediately prior to my treatment.

I understand that this establishment and its staff have the right to refuse treatment if I display any of the following symptoms; fever, cough, loss of taste or smell, shortness of breath, difficulty breathing, sore throat or runny nose.

I have read, understood, and completed this questionnaire truthfully. I agree that this constitutes full disclosure and that it supercedes any previous verbal or written disclosures.

Clinic Address:

121B 14 Street NW Calgary AB T2N 1Z6

Covid19 Consent

Clinic Address:

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