Medical History Update

Have there been any changes to your Medical history since your last appointment? *

COVID-19 Update Form

Be sure that the information you give is accurate and complete. Please get immediate medical attention if you have any severe COVID-19 signs.
In the last 10 days, have you:
Had a positive COVID test or are waiting for results? *
Had any symptoms of COVID or a Cold/Flu (New-onset Sore Throat, Runny Nose, Cough, Fever, Fatigue, Chills, Loss of sense of smell or taste)? *
Been in contact with someone with COVID? *
If you have answered "YES" to one or more of the previous questions, please contact the business right away to discuss if your appointment should be rescheduled for a future date.

Business COVID-19 Declaration

I agree to the following:

Premiere Touch Therapeutic Massage, LLC is following these enhanced procedures to prevent the spread of COVID-19:

* Prepayment for services available if clients prefer contactless checkout.

* Additional time included between appointments to prevent guest contact with each other.

* Guests accompanying those scheduled for services are not permitted.

* Each guest is required to use hand sanitizer or wash hands upon arrival.

* Your Therapist will thoroughly clean hands and wear sterile gloves during all consultations and treatments.

* Your Therapist will wear the following protective gear: mask and (optional) face guard for each appointment.

* All product bottles used during the treatment will be placed in a separate container for disinfection and disposable items will be used when possible.

* All surfaces will be wiped thoroughly with hospital-grade disinfectant before and after each client according to the manufacturer's directions and sterilized at the end of each day.

I understand that Premiere Touch Therapeutic Massage, LLC cannot be held liable for any exposure to the COVID-19 virus caused by misinformation on this form or the health history provided by each client. *
To assist us in our efforts of reducing the spread of COVID-19, please do not come directly in upon arrival. We ask that you wait in your vehicle or social distance yourself in the downstairs lobby until you receive a phone call. *


By signing below, I agree with each statement above and release Premiere Touch Therapeutic Massage, LLC from any and all liability for the unintentional exposure or harm due to COVID-19. Premiere Touch Therapeutic Massage agrees to abide by these standards and affirms the same. *

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