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Due to the ongoing outbreak of the novel Coronavirus (COVID-19), we are taking extra precautions with every client to confirm recent health + exposure history and have enhanced sanitation/disinfecting procedures in compliance with CDC guidance. Symptoms of COVID-19 include: fever, fatigue, dry cough, sore throat, shortness of breath. Please fill out this form at least 1 week prior to receiving services from us. Thank you for your cooperation!

I understand that this business service includes physical touch and close proximity over an extended period of time. Because of this, there may be an elevated risk of disease transmission, including COVID-19. By signing this form, I acknowledge that I am aware of the risks involved from receiving service from this business at this time, I voluntarily agree to assume those risks, and I release and hold harmless this business from any and all claims related to receiving service. I give my consent to receive service from this business.

Thanks for submitting!

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