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Covid-19 Consent Form

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  • I understand that Johnson Eyecare and Eyewear, its doctors and staff are taking precautions to limit any potential exposure I may have to the COVID-19 virus. I also understand that there is no definitive way to eliminate potential exposure by one hundred percent.

    My signature below signifies that I agree that I will not hold Johnson Eyecare and Eyewear or any of its doctors or staff personally responsible should I, or someone I come in contact with, become positive or presumptively positive with a COVID-19 diagnosis. There are certain inherent risks associated with an eye exam and eye care visit during a pandemic and I assume full responsibility for personal illness, injury, loss or damage arising out of my visit. I understand that COVID-19 infections can lead to illness, disability, or even death and knowingly take the risk of exposure as I deem my eye care to be essential to the maintenance of my vision.

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