Coronavirus disease 2019 (COVID-19) Liability Release WAIVER - must be submitted before your appointment

Due to the outbreak of the COVID-19 pandemic, we are taking extra precautions with the intake of each client, health history review, as well as disinfecting and sanitation practices.

Essa Dora Salon & Spa LLC and all its employees within the facility agree that they abide by these same standards and affirm the same. We also affirm that we have improved and expanded our sanitation protocols to more thoroughly fight the spread of COVID-19 and other communicable conditions.

Please read this waiver in its entirety and complete the required(*) fields below.

According to the Centers for Disease Control and Prevention, people with these symptoms may have COVID-19:

● Fever
● Cough
● Difficulty breathing
● Fatigue
other less common symptoms can be obtained from the CDC.gov website

The guidelines agreed upon in this waiver apply towards any current and future appointments.

I understand the above symptoms and affirm that I will not enter the salon for 14 days after I, or any household member, has experienced the symptoms listed above, or until I have tested negative for COVID-19 after experiencing symptoms.

If I, or any household member, has tested positive for COVID-19, I affirm that I will not enter the salon for the greater of 14 days, or until I have tested negative for COVID-19.

If I, or any household member, has come into close contact with someone outside of my household who has tested positive for COVID-19, I affirm that I will not enter the salon for 14 days, or until I have tested negative for COVID-19 after coming into close contact with such person.

If I, or any household member, has traveled outside of the Chicagoland area to an international or domestic location considered a “hot spot” for COVID-19 infections, I affirm I will not enter the salon for 14 days upon returning, or until I have tested negative for COVID-19 after returning from travel.

I agree that I am entering the salon at my own risk, releasing Essa Dora Salon & Spa LLC and its employees from any liabilities relating to COVID-19. I agree to comply with all of the safety measures and protocols implemented by Essa Dora Salon & Spa LLC and its employees and understand that they are subject to change at any given time or as deemed necessary. Failure to comply with these written instructions or verbal instructions from staff may result in forfeiture of my appointment.

I understand that Essa Dora Salon & Spa LLC and its employees cannot be held liable for any exposure to the virus or any other contagion caused by misinformation on this form or the health history provided by each client.

If you are signing on behalf of someone else, please include your first and last name, followed by "on behalf of" their first and last name

By submitting a completed waiver, I agree to each above statement and release Essa Dora Salon & Spa LLC and its employees from any and all liabilities for the unintentional exposure or harm due to COVID-19.