Consent Form

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Consent Form

Consent for Services During Covid-19 Public Health Crises

This document contains important information about our decision ( yours and Muggymoose LLC ) to agree to in person sessiuons during COVID-19. Please read this carefully and let us know if you have any questions. When you sign this document, it will be an official agreement between us. Our studio and therapists are also working hard to do all that we ask you to do. This is a collective effort of all of us to keep our community healthy.

Risk of Meeting in Person: You understand that by coming to the studio, you are assuming the risk of exposure to COVID. This risk may increase if you have not been social distancing or do not wear a mask.. We, as therapists, will continue to wear masks for the undetermined future

"Your and Our Responsibility to Minimize Exposure: At our studio, vaccinated and non-vaccinated clients must remain masked in our public space. Masking during massage sessions will be discussed with your therapist once you are there. Therapists, though fully vaccinated, will also remain masked.

Please check the boxes that you understand and agree to these actions *

I will wear a mask covering nose and mouth when I come to the studio and wear it in the entry area.

I may or may not wear a mask during my session, based on discussion with my therapist.

If I learn after my appointment that I, or someone I have been in contact with has COVID, I will inform the studio

I have not been in contact with anyone who has tested positive for COVID-19

I have not tested positive for COVID-19 in the past 10 days

I have not shown symptoms of COVID-19

Required

Signature ( sign by printing name ) *

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