Client Covid19 Check In

Thank you for choosing LRS for your wellness needs. Please check in prior to your services.

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Have you travelled outside the country in the last 2 weeks? *

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Have you come into contact with anyone who has Covid-19 in the last 2 weeks? *

YesNo

Have you experienced shortness of breath, fever, muscle aches?

YesNo

COVID-19 Liability Waiver I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing. I further acknowledge that Ladies Retreat Spa has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19. I further acknowledge that Ladies Retreat Spa can not guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to staff, and other spa clients and their families. I voluntarily seek services provided by Ladies Retreat Spa and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending my appointment. I attest that: * I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell. * I have not traveled internationally within the last 14 days. * I have not traveled to a highly impacted area within the last 14 days. * I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19. * I am following all public health recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19. I hereby release and agree to hold Ladies Retreat Spa harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of the salon, or that may otherwise arise in any way in connection with any services received from Ladies Retreat Spa. I understand that this release discharges Ladies Retreat Spa from any liability or claim that I, my heirs, or any personal representatives may have against the spa with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from Ladies Retreat Spa. This liability waiver and release extends to the spa together with all owners, partners, and employees.*

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