Patient Resources

PATIENT RESOURCES

POST BBL / IPL

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PRE ULTHERAPY

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POST VEIN

POST HAIR REMOVAL

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POST INJECTIONS

POST MLP & PRO FRAC

POST SCARLET & MN

Covid-19 Health Declaration

First Name

Last Name

I understand that I am opting for an elective treatment that is not urgent and may not be medically necessary.

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.

Skin Nirvana Med Spa is following these enhanced procedures to prevent the spread of COVID-19:
- Contactless checkout
- Additional time included between appointments to prevent client contact with each other
- Guests accompanying those scheduled for services discouraged
- Each client required to wash hands upon arrival and before leaving
- All surfaces will be wiped thoroughly with hospital grade disinfectant before and after each client

Refrain from cell phone use in facility

By initialing below, you agree to each statement above and release Skin Nirvana Med Spa from any and all liability for the unintentional exposure or harm due to COVID-19.

Skin Nirvana Med Spa agrees to abide by these standards and affirms the same.

Initial to agree

Select a date

Thanks for submitting!

A Higher Level of Skincare

Since 2005