Covid19 Information

Your Name*
Date*
Date Format: MM slash DD slash YYYY
Have you had a fever in the last 24 hours of the 100°F or above?*
- Yes
- No
Do you now, or have you recently had, any respiratory or flu like symptoms sore throat or shortness of breath?*
- 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
*
- A 2 metre social distancing rule will be in place according to Government Guidelines wherever possible
Hand Sanitiser will be made available for before and after your workout
Glovers will be provided
All machines and equipment and door handles will be cleaned after each workout
Consent for Traning Session
Consent for Treatment*
- Yes
I understand that, because massage therapy work 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 singning this form, I acknowledge that I amaware of the risks involved from receiving treatment at this time, I voluntarily agree to assume those risks, and I relase and hold harmless the practitioner/business from any claims related thereto. I give my consent to receive treatment from this practitioner.
Client Signature*