Additional Patient Consent for Treatment During COVID-19 Pandemic
I understand that I am opting for an elective medical consultation/treatment/procedure.
I understand that the novel coronavirus, the World Health Organization has declared COVID-19, a worldwide pandemic and that COVID-19 is extremely contagious and is believed to spread by person- to-person contact; and, as a result, social distancing is recommended. This is not entirely possible with my proposed treatment; however, I am satisfied that safety measures are in place to minimise risk as much as possible, and patient contact will be kept to an absolute minimum in line with medical need.
I understand the Management and Clinical Staff are closely monitoring the COVID-19 situation and have put in place reasonable preventative measures aimed to reduce the spread of COVID-19. However, given the nature of the virus, I understand there is an inherent risk of becoming infected with COVID-19 by virtue of proceeding with treatment. I hereby acknowledge and assume the risk of becoming infected with COVID-19 through this elective consultation/medical treatment/procedure, and I give my express permission to proceed.
I understand the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious. I understand that COVID-19 can cause additional health risks, some of which may not currently be known at this time, in addition to those risks associated with the medical consultation/ treatment/procedure itself.
I have been given the option to defer my medical consultation/treatment/procedure to a later date. However, I understand all the potential risks, including but not limited to the potential short-term and long-term complications related to COVID-19, and I would like to proceed with my desired medical treatment/procedure.
The Haus of Brows is not liable for unsatisfactory outcome as result of Force Majeure Events ie The Corona Virus. The patient will not be entitled to a refund as it is not the fault of The Haus of Brows and Force Majeure Events are unexpected.
I confirm that I am not presenting with any of the following symptoms of COVOID-19 listed below:
• Shortness of Breath
• Loss of Sense of Taste or Smell
• Dry Cough
• Runny Nose
• Sore Throat
I understand that air travel significantly increases my risk of contracting and transmitting the COVID- 19 virus. I confirm that I have not travelled in the past 15 days.
I understand that The Haus of Brows requires a minimum 2 weeks notice of appointment cancellation and will be charged up to the full treatment price if adequate notice is not given. It is down to The Haus of Brows discretion how much to charge the card on file if appointment is missed. If notice of the COVID19 vaccine is give WITHIN the 2 week window then The Haus of Brows is within its T&C's to class this as a missed appointment and charge the card.
It is mandatory that you do not have any semi permanent brow treatment 2 weeks before or 2 weeks after the COVID19 vaccine. If you have treatment within these times and do not inform The Haus of Brows of your vaccine date, The Haus of Brows is therefore not liable for any contraindications of the treatment performed.
I confirm that if I develop COVID-19 symptoms following my medical consultation/treatment/procedure or a known contact of mine develops symptoms, I will immediately inform the practitioner to enable appropriate measures to be put in place and contact tracing to commence.