COVID-19 Pandemic Tattoo Appointment Consent Form
Please fill this out and return it 24 hours prior to your scheduled appointment. Should anything change within the 24 hours before your appointment, please contact us immediately.
Email address *
Client's Full Name *
Client's Address *
Client's Phone Number *
I knowingly and willingly consent to have tattoo and/or piercing service(s) during the COVID-19 pandemic. *
I understand the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious. It is impossible to determine who has it and who does not, given the current limits in virus testing. *
I understand that due to the frequency of visits of other clients, the characteristics of the virus, and the characteristics of tattoo services, that I have an elevated risk of contracting the virus simply by being in the shop. *
I confirm by checking each box that I am NOT presenting any of the following symptoms of COVID-19 listed below: *
I confirm that if I present symptoms between now and my appointment that I will cancel. I also understand that I can be denied service, and still charged for my confirmed appointment, if I show up with symptoms. *
I confirm that I have NOT been around anyone with these symptoms in the past 14 days. *
Do you live with anyone who is sick or quarantined? *
If you DO live with someone who was sick or quarantined, please explain how long ago. If not please write "N/A" *
I have been in any contact with someone who is/was sick or has quarantined. *
If you answered YES to the previous question, please explain how long ago. If not please write "N/A". *
By checking each box I am acknowledging that I know I am required to do the following before coming to the shop: * *
By checking each box I am acknowledging that I understand the following procedures for the "Arrival process": *
To prevent the spread of contagious viruses and to help protect each other, I understand that I will have to follow the shop’s strict guidelines. *
I understand that air travel significantly increases my risk of contracting and transmitting the COVID-19 virus. And I understand that the CDC, OSHA, and California Board of Cosmetology and Barbers recommend social distancing of at least 6 feet. *
I verify that I have not traveled outside the United States in the past 14 days to countries that have been affected by COVID-19. *
Due to government-mandated health & safety requirements placed on our industry, your artist and Art of the Heart Tattoo, has added a modest $10.00 fee to your service to offset the additional expenses. We appreciate your understanding and support. *
Due to scheduling differently, your artist is not able to be as flexible with their schedule. If you are more than 10 minutes late, your artist will be unable to take you and you will still be responsible for payment of the appointment as if it is a "no show". *
Art of the Heart's pre-Covid-19 cancelation policy: You must give 24 hours notice on all appointments otherwise you will be charged in full for the scheduled appointment. No shows are also charged the full amount. Due to Covid-19, Art of the Heart will not charge any cancelation fee for canceling due to suddenly feeling symptoms or finding out you have been exposed to COVID. Please communicate the change with your artist as soon as possible and be mindful of their time. Thank you! *
By signing this form I am releasing Gus Byrd, any other artist working at Art of the Heart, and any other person associated with Art of the Heart of all liability surrounding Covid-19. By clicking "I understand" you are agreeing to these terms. *
Thank You for taking the time to fill this form out! We appreciate you so much and your health and safety is of the utmost importance to us. Please let us know below if there are any other questions or concerns and as always please feel free to contact us. See ya soon!
A copy of your responses will be emailed to the address you provided.
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