Affirmation of Isolation

COVID-19 Positive Individuals

If you have tested positive, New York State Department of Health requires you to isolate for at least 5 days from your onset of symptoms, or from the date of your test if you had no symptoms.

Herkimer County Public Health and New York State Public Health are no longer contact tracing.  If you test positive (whether you are tested at a clinic or with an at-home kit), immediately isolate yourself and notify your close contacts and your workplace or school.  When you have met the requirements for release from isolation, you may complete a self-attestation form as legal documentation for your isolation or quarantine and for New York Paid Family Leave COVID-19 claims:

This form is for your own use, DO NOT submit it to the Herkimer County Health Department. Please either print and fill out this form for your records or fill out online and save it to your computer.