COVID-19 Risk Informed Consent

I understand that the novel coronavirus, COVID 19, has been declared a worldwide pandemic by the World Health Organization. I further understand that COVID-19 is extremely contagious and is believed to spread by person-to-person contact; and, as a result, federal and state health agencies recommend social distancing. I recognize that all Maggie Austin staff are closely monitoring the situation and have put in place reasonable preventive measures aimed at reducing the spread of COVID-19. However, given the nature of the virus, I understand that there is an inherent risk of becoming infected with COVID-19 by virtue of attending this workshop. I hereby acknowledge and assume the risk of becoming infected with COVID-19 through this workshop and give my express permission for Maggie Austin staff to proceed with instruction.

I understand that even if I have tested for COVID-19 and received a negative test result, the test may fail to detect the virus or I may contract COVID-19 after the test. I also understand that some people infected with COVID-19 may be asymptomatic.

I understand that possible exposure to COVID-19 before, during, or after my workshop may result in the following: a positive COVID-19 diagnosis, extended quarantine/self-isolation, additional tests, and/or hospitalization. I understand that COVID-19 may cause unknown complications in addition to the risks described herein.

I understand all the potential risks, including but not limited to the potential complications related to COVID-19 and I would like to proceed with my instruction.

I understand the explanation and consent to instruction.


Signature _______________________________________________________


Printed Name ___________________________________       Date _________