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Covid-19 Consent Form

1: Client Information:

2: I understand that I am opting for an elective treatment/procedure/service that is not urgent and may not be medically necessary and is a service solely by my personal choice. I also understand that the novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. I further understand that COVID-19 is extremely contagious and is believed to spread by person-to-person contact; and, as a result, federal and state health agencies recommend social distancing for the immediate and fore see able future. I recognize that the medical providers and Posh Beauty Artistry are closely monitoring this situation and have put in place reasonable preventative measures aimed to reduce the spread of COVID-19 and provide a safer environment for their clients. However, given the nature of the virus, I understand there is an inherent risk of becoming infected with COVID-19 by virtue of proceeding with this elective treatment/procedure/service.

2: I acknowledge the above statement.

3: I hereby acknowledge and assume the risk of becoming infected with COVID19 through this elective treatment/procedure/service, and I give my permission for Posh Beauty Artistry to proceed.

3: I acknowledge the above statement.

4: I understand that, even if I have been tested for COVID and received a negative test result, the tests in some cases may fail to detect the virus or I may have contracted COVID after the test. I understand that, if I have a COVID-19 infection, and even if I do not have any symptoms for the same, proceeding with this elective treatment/procedure/service can lead to a higher chance of complication and death.

4: I acknowledge the above statement.

5: I understand that possible exposure to COVID-19 before/during/after my treatment/procedure/service may result in the following: a positive COVID-19 diagnosis, extended quarantine/self-isolation, additional tests, hospitalization that may require medical therapy, Intensive Care treatment, and possible need for intubation/ventilator support, short-term or long-term intubation, other potential complications, and the risk of death.

5: I acknowledge the above statement.

6: In addition, after my elective treatment/procedure/service, I may need additional care that may require me to go to an emergency room or a hospital. I understand that COVID-19 may cause additional risks, some, or many of which may not currently be known at this time, in addition to the risks described herein, as well as those risks for the treatment/procedure/service itself. I have been given the option to defer my treatment/procedure/service to a later date. However, I understand all the potential risks, including but not limited to the potential short-term and long-term complications related to COVID-19, and I would like to proceed with my desired/elective treatment/procedure/service. While visiting Posh Beauty Artistry I agree to comply with COVID-19 policies so long as the business is made to enforce them in accordance with local and CDC guidelines. This may include: having my temperature taken, using hand sanitizer or washing my hands when guided, placing my personal belongings into a plastic bag while visiting, and wearing a mask for the duration of my treatment. I assume all risks and associated costs that may occur, and do not hold Posh Beauty Artistry, or its’ affiliates liable in any way.

6: I acknowledge the above statement.

Thanks for submitting!

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