This form may be used for Isolation Release or for New York Paid Family Leave COVID-19 claims as if it was an individual Order for Isolation issued by the New York State Department of Health or relevant County’s Commissioner of Health or designee.

Nov 27, 2023 · This guideline provides recommendations for isolation precautions in healthcare settings.

Isolation Order/Affirmation of Isolation Form. If you or your child or dependent has tested positive for COVID-19 and have been in isolation, your employer/school may require the New York State Department of Health AFFIRMATION OF ISOLATION. This self-reporting form serves as your Order of Isolation and can be submitted for New York Paid Family ...

Complete if you or your child has tested positive for COVID-19 and have been in isolation. Use a separate form for each positive person. Do NOT submit to the Health Department—this form is for your use as legal documentation of your isolation and …

Isolation keeps someone who is infected with COVID-19 away from others. If you test positive for COVID-19 regardless of vaccination status, isolate immediately . If you test positive for COVID-19 , you should isolate yourself from others for at least 5 full days.

Mar 1, 2024 · If you need an isolation order or release of isolation, fill out the appropriate form below. You will automatically receive an email Isolation Notification. This is what you can forward on to your employer as documentation of your need to isolate & not go to work. You can use the I need an Isolation Release tab to get an emailed Isolation Release.

Feb 6, 2022 · The Affirmation of Isolation form requires individuals to provide dates of isolation for themselves or their child or dependent based on testing positive for COVID-19.

This form may be used for Isolation Release or for New York Paid Family Leave COVID-19 claims as if it was an individual Order for Isolation issued by the New York State Department of Health or relevant County’s Commissioner of Health or designee.

This form may be used for Quarantine Release, quarantine leave benefits, or for New York Paid Family Leave COVID-19 claims as if it was an individual Order for Quarantine issued by the New York State Department of Health or relevant County’s Commissioner of Health or designee.

AFFIRMATION OF ISOLATION. Complete if you have tested positive for COVID-19 and have been in isolation. I, (print name) , do hereby affirm that I isolated from (date) through (date) consistent with guidance