You will have to sign one of these forms when you come into CoyDog Botanicals & Yoga for the very first time.

 

 

As you are probably aware, Coronavirus COVID-19 is a highly contagious virus that is spread from direct contact with any object and is also transmissible through the air from an infected person. By leaving your house you may have already been in contact with this contagious disease. The COVID-19 virus is easily spread and can cause permanent lung problems and even death.

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High Risk clients are recommended to stay at home at this time; however, there are daily activities that are essential to your health and well-being. We highly recommend high-risk clients avoid leaving their homes unless necessary.

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Healthcare services that may be essential for your health, at this time, we are committing our services to our clients and have taken extra precautions to minimize the spread of COVID-19. The best general guidance will continue to come from the Center for Disease Control and Prevention, and the World Health Organization.

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Warning Signs / Symptoms of COVID-19

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Fever

Cough

Tiredness

Difficulty breathing

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High-Risk Patients

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Over 60 years old

Diabetic 

Heart Disease

High Blood Pressure

Asthma & Other Pulmonary Conditions

Undergoing Chemotherapy

Immunocompromised

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I further acknowledge that I am voluntarily participating in any services or activities at CoyDog Botanicals & Yoga with the full knowledge and understanding that said activities are taking place during the COVID-19 pandemic. I understand that while at CoyDoy Botanicals & Yoga and its employees and contractors will abide by all local, state, and federal government laws and guidelines, as well as the CDC guidelines, in an attempt to keep employees and guests safe, that I assume ALL risks associated with participation in said activities during said pandemic, including but not limited to: any illness and any adverse physical and/or psychological effects from the same and/or loss of any income or other monetary loss incurred as a result of effects of said illness and/or cost incurred in the treatment of the same. I accept full and total responsibility for my own health and agree to release, hold harmless, and indemnify, to the extent permitted by the law, CoyDog Botanicals & Yoga, its employees, and contractors from any liability for any illness, injury, loss, or damages I may incur as a result of contracting COVID-19 as a result of engaging I said above reference activities.

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By signing this form, I acknowledge that I may contract COVID-19 anywhere including this facility, and I hold all the CoyDog Botanicals & Yoga healthcare providers and staff harmless for any health-related conditions that may come from Coronavirus COVID-19.

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Vistor's Name (PRINT) _______________________________________________________ Signature ___________________________________________ Date ___________________

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Witness Name (PRINT) _______________________________________________________ Signature __________________________________________ Date ____________________

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