COVID-19 Liability Waiver

COVID-19 is a highly contagious virus that spreads from person to person. In addition to long-held and explicit sanitation measures this business has always adhered to, new preventative measures have been put in place to further reduce the spread of this novel coronavirus. However, these best practices still offer no guarantee regarding your potential risk of being infected.

Have you had a fever in the last 24 hours of 100°F or above?*
- Yes
- No
Have you been in contact with anyone in the last 14 days who has been diagnosed with COVID-19 or has coronavirus type symptoms?*
- Yes
- No
Do you now, or have you recently had, any respiratory or flu symptoms, sore throat, or shortness of breath?*
- Yes
- No
Name*
First Last
Date Of Birth*
MM
DD
YYYY
Email*
Consent for Treatment*
I agree
I understand that, because esthetics involves maintained touch and close physical proximity over an extended period of time, there may be an elevated risk of disease transmission, including COVID-19. By signing this form, I acknowledge that I am aware of the risks involved from receiving treatment at this time, I voluntarily agree to assume those risks, and I release and hold harmless the practitioner/business from any claims related thereto. I give my consent to receive treatment from this practitioner.
Comments
This field is for validation purposes and should be left unchanged.

We will follow the required guidelines and our own Le Visage health, safety, and sanitation protocols. Therefore, until further notice, we will book appointments for a minimum of 1 hour or longer.

Walk-ins are not accepted.

All appointments must be pre-booked by phone (857) 284 -7680.

A credit card will be required to book an appointment, which may be used for touchless checkout.

Make sure we have the best phone number to reach you.

Clients who are unable to keep their appointments due to illness will need to wait two weeks before rebooking.

The spa waiting area is temporarily closed.

Please do not bring anyone else to your appointment unless you are a minor or have a disability that requires personal assistance.

To buy products or a Le Visage gift card, please do so on our website here, so you don’t have to come to the spa just for those.

You must wear a mask entering the building and into your treatment room.

You may be asked to remove your mask only if it’s necessary during your service.

Hand sanitizers will be available all through the spa; you may wash your hands as often as you like.

Please, tip your service provider directly in the room as we won’t make any change.

We will call you when your service provider is ready to take care of you. Please, wait upstairs in the lobby or outside of the building.

Please fill out our COVID 19 liability waiver online here on the day of your appointment.

Thank you for your patience and understanding.
A Bientot

Virtual Bisous,
Anne Cecile & The Le Visage Team

COVID-19 Liability Waiver

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