The above information given by me is true to the best of my knowledge. I fully understand and acknowledge that withholding or misrepresentation of any information is highly unethical and against the interest of the larger population during this pandemic.
I have been made aware that procedures create an ultra-fine spray that may transmit the Covid-19 virus. 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 also understand that, due to the contagious nature of the disease and characteristics of the procedures, I have an increased risk of contracting the virus simply by being in a clinic in spite of the best disinfection protocols applied.
I fully understand and acknowledge that I may be an asymptomatic carrier of the disease and hence will strictly comply with all safety precautions and protocols advised. In the eventuality of my testing COVID positive at a later date, I will not hold the Clinic provider/staff/set-up responsible for it. I hereby knowingly and willingly give consent to have my procedure completed during the COVID pandemic.