Treasure Hill Wellness Form

VISITOR WELLNESS CONFIRMATION FORM

Please submit this form no later than the day prior to your appointment. If you fail to submit the form you will not be permitted entry into the Design Studio.

Date:

Please provide a valid date.

Site/Lot#:

Please provide a valid site/lot.

Name:

Please provide a valid Name.

Contact#:

Please provide a valid contact.

I confirm (check all that apply):

I have been free of all signs of illness, including cough, fever, trouble breathing or any other respiratory issue for the past 3 weeks.

You must agree before submitting.

I do not have a confirmed case of COVID-19 (and I am not under investigation for a potential case of COVID-19)

You must agree before submitting.

I have not, in the past 14 days, been in close contact with anyone with a confirmed case of COVID-19 (or anyone under investigation for a potential case of COVID-19)

You must agree before submitting.

In the past 14 days, I have not travelled outside of Canada

You must agree before submitting.

I VERIFY THE REPRESENTATIONS MADE ABOVE ARE ACCURATE AND THAT I WILL ABIDE BY THE GUIDELINES SET OUT BELOW. I UNDERSTAND THAT THE DESIGN STUDIO MAY, FOR THE SAFETY AND HEALTH OF ITS EMPLOYEES, DENY ENTRY OR ASK PEOPLE TO LEAVE AS IT DETERMINES NECESSARY IN ITS SOLE AND UNFETTERED DISCRETION.

Purchaser Signature:

PLEASE BE ADVISED THAT THESE GUIDELINES MUST BE FOLLOWED [CHECK & SIGN IF ACKNOWLEDGED]:

Only purchaser(s) who signed the Agreement of Purchase and Sale (APS) are permitted to attend. A maximum of 2 person(s) are allowed per appointment.

You must agree before submitting.

All purchaser(s) entering the Design Studio will be required to have their body temperature taken at reception.

You must agree before submitting.

Children to be left at home as no children under 18 will be permitted entry.

You must agree before submitting.

There will be no outside food and beverages permitted into the Design Studio.

You must agree before submitting.

Masks and gloves will be required to be worn at all times during the appointment in a proper manner [covering both mouth and nose areas]

You must agree before submitting.

You will be assigned a stationary table in the Design Studio where the appointment will be conducted.

You must agree before submitting.

Handling of samples, free-roam and re-entries to the studio will not be permitted for the entirety of the appointment otherwise approved by staff. However, bathroom breaks will be allowed.

You must agree before submitting.

Please ensure you practice physical distancing while visiting our Design Studio maintaining a minimum of a 6ft distance from all other parties present at the time.

You must agree before submitting.

If you begin feeling ill (cough, cold, flu like symptoms) on the day of your appointment, we kindly ask you to reschedule your appointment (you will not be charged the cancellation fee if cancellation is due to illness).

You must agree before submitting.

Purchaser Signature:

Should the Purchaser wish to name a designate in their place, the designate may only attend if preapproved by the Vendor and if the designate remits this form. Please note that as a result of limited staff and the staggering of shifts, the Design Studio may be required to cancel and/or reschedule your appointment with short notice.

© 2021 Treasure Hill

Treasurehill.com

2026/02/25 08:43:19

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