COVID-19 DECLARATION | Nextleveltattoos

Covid-19 Health Declaration & Consent form

How are you feeling today?

I,

First Name

Last Name

knowingly and willingly consent to having a tattoo procedure completed during the COVID-19 Pandemic. I also aknowledge that by signing and submitting this form I am providing accurate.

I understand that the COVID-19 Virus has an incubation period during which carriers of the virus my not show symptoms but may be highly contagious. Given the current limit in virus testing, it is impossible to determine who and who does not have COVID-19.

I understand that despite the upmost cleaning and disinfecting the tattoo equipement, chairs, fixtures and studio area, due to the characteristics of the virus, that i have elevated the risk for myself/family member/friends of contracting the virus by attending the tattoo appointment.

I confirm that I and any family member or friend attending the appointment tattoo session is not presenting and of the following symptoms of COVID-19. Fever; - Shortness of Breath - Dry cough - Loss of taste or smell - Sore throat - Runny nose

The Government recommends social distancing of 2m and i understand that this is not always possible within a tattoo studio/procedure, however staff will wear protective masks if social distancing can not be practised. I verify that I/We have not travelled outside the United Kingdom within the past 14 days. I verify that I/We have not travelled within the United Kingdom via Commercial airline, bus or train within the past 14 days. I verify that I/We present at the tattoo procedure have not been a part of any large group gatherings.

Initials (Signature)

Date

By clicking on the submission button below, I declare that the information I’ve provided is accurate & complete to the best of my knowledge.

Thanks for submitting!