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 NA

 

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: ______________________

Studio Address

400 North Potomac Street

Hagerstown, Maryland 21740

 

PH:  240.500.8547

EMAIL:  mytanique@gmail.com

© 2014 Tanique Custom Airbrush Spray Tan & Makeup Studio.  

All Rights Reserved.

Studio Hours

Monday         9:30am—8:00pm

Tuesday        9:30am—8:00pm

Wednesday  9:30am—8:00pm

Thursday      9:30am—8:00pm

Friday            9:30am—8:00pm

Saturday       9:00am—5:00pm

*Service Policy: Children are not allowed in the service areas unless they are receiving the service.  Children under 13 must be with an adult at all times in the waiting areas.

*Cancellation Policy: Tanique requires a 24 hour notice for all cancellations. 

*Our Policy: We don't do refunds