Release of Liability

I agree to the following:

I understand the below symptoms and affirm that I, as well as all household members, do not currently have, nor have experienced the symptoms listed above WITHIN THE LAST 30 DAYS

fever/chills
shortness of breath or difficulty breathing
fatigue
muscle or body aches
headache
sore throat
loss of smell or taste cough
cough
congestion/runny nose
nausea or vomiting
diarrhea

I affirm that I, as well as all household members, have not been diagnosed with COVID-19 WITHIN THE PAST 30 DAYS.

I affirm that I, as well as all household members, have not knowingly been exposed to anyone diagnosed with COVID-19 WITHIN THE PAST 30 DAYS.

I affirm that I, as well as all household members, have not traveled outside of the country, or to any city considered to be a "hot spot" for COVID-19 infections WITHIN THE PAST 30 DAYS.

I understand that BLOOM MORRISTOWN cannot be held liable for any exposure to the COVID-19 virus caused by misinformation on this form or the health history provided by each client or staff member.

I understand that BLOOM MORRISTOWN has a 24 hour cancellation policy. If you cancel AFTER the 24 hour mark, or no show your appointment, you will be charged 100% of the cost for the services booked on that day.

BLOOM MORRISTOWN is following these enhanced procedures to prevent the spread of COVID-19:

Contactless payment
All surfaces will be wiped thoroughly with hospital grade disinfectant before and after each client according to the manufacturer's directions
All Bloom employees and clients are required to wear a face mask, upon entry into Bloom Morristown, in accordance with NJ safety guidelines
All Bloom employees and clients will have their temperature checked upon entering the building
Bloom will only service clients with appointments. All others will have to wait outside
Each Bloom employee and client is required to wash their hands upon entering the building
Each service provider will wash their hands, wear a sterilized robe and wear a face mask for each client
Clients are allowed one personal item with them in the building
We will not serve beverages, food or reading materials
All tools will continued to be sterilized before and after each client
All skincare product bottles used during the treatment will be placed in a separate container for disinfection, and disposable items will be used when possible
Should you forget your mask, Bloom Morristown will have masks available for purchase.
In an effort to minimize unnecessary exposure to surfaces for the time being, our staff will not be able to touch coins or credit cards for the meters. Clients will be responsible to monitor their meters.

By signing below, I agree to each statement above and release Bloom Morristown from any and all liability for the unintentional exposure or harm due to COVID-19.

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First Name *

Last Name *

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E-mail Address *

By typing and submitting, this serves as a Digital Signature and verifies that you fully agree to our safety policy for our services. This digital signature holds the same authority as a handwritten one. Thank you.

Signature *

BLOOM MORRISTOWN is following these enhanced procedures to prevent the spread of COVID-19:

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