Example COVID-19 Liability Release Waiver for Clients

Due to the 2019-2020 outbreak of the novel Coronavirus (COVID-19), our business is

taking extra precautions with the care of every client to include health history review and

enhanced sanitation/disinfecting procedures in compliance with CDC guidance.

Symptoms of COVID-19 include:

• Fever

• Fatigue

• Dry Cough

• Difficulty Breathing

I agree to the following:

• I understand the above symptoms and affirm that I, as well as all household

members, do not currently have, nor have experienced the symptoms listed above

within the last 14 days.

• I affirm that I, as well as all household members, have not been diagnosed with

COVID-19 within the past 30 days.

• I affirm that I, as well as all household members, have not knowingly been exposed

to anyone diagnosed with COVID-19 within the past 30 days.

• I affirm that I, as well as all household members, have not traveled outside of the

country or to any city considered to be a “hot spot” for COVID-19 infections within

the past 30-days.

• I understand that [insert business name here] 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.

Our business is following theses enhanced procedures to prevent the spread of COVID-19:

• [list how your business is enhancing protection for clients amid COVID-19]

By signing below, I agree to each statement above and release [name of business] from any

and all liability for unintentional exposure or harm due to COVID-19.