***You will be prompted to fill out the waiver shown below when scheduling your appointment. You do not need to print out this waiver. Our booking system will automatically prompt you to complete it before your appointment can take place. Please visit your account on https://www.vagaro.com/tanique to fill out this form.

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Below you will find an example of our COVID-19 Waiver:

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COVID-19 WAIVER – PERSONAL SERVICES

 

Client Name: _______________________________________  Phone: __________________________

 

Do you have any of the following symptoms?

• Fever

• Dry Cough

• Body Aches

• Headaches

• Soar Throat

• Runny Nose

• Tiredness

• Shortness of Breath

• None of the Above

 

Have you been in contact with anyone who has a confirmed case of COVID-19 in the past 14 days?    YES or NO

 

If you’re a healthcare provider and the answer is YES, was this exposure without proper personal protective equipment (PPE)?    YES or NO or N/A

 

Have you been out of the state of MD in the past 14 days?  YES or NO

 

RELEASE OF LIABILITY WAIVER

State of Maryland

I hereby agree that Tanique and Blown Dry Bar  has a proper sanitation and disinfection plan in place and is not responsible for any accidental transmission of COVID-19 that could occur by being in their business or within close proximity of each other.  I also agree that if I become symptomatic within 14 days of my visit, I will notify the business immediately.

 

 

 

Signature: _________________________________________________ Date: ______________________

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