The New York State Department of Health (NYSDOH) has made available on its website self-attesting quarantine and isolation forms that employees may use to demonstrate eligibility for the state’s COVID-19 quarantine leave law or for other purposes in which they must verify quarantine or isolation for themselves or their child/dependent (such as for return to school purposes).

As we have previously reported, the New York State’s COVID-19 quarantine leave law requires employers to provide certain leave for employees subject to a mandatory or precautionary order of quarantine or isolation due to COVID-19, as well as for employees caring for a minor or dependent child who is required to quarantine.

Previously, the law required employees seeking protected leave due to COVID-19 be subject to an order of quarantine or isolation issued by the State of New York, a state or local health department, or any other governmental entity. Now, however, employees can provide a self-attestation form rather than obtain an order of quarantine or isolation from a government entity or treating healthcare provider.

Affirmation of Quarantine Form

The Affirmation of Quarantine form requires individuals to confirm that they (or their child or dependent): (i) have been identified as a close contact to a COVID-19 positive person during their contagious period; (ii) were not up to date on COVID-19 vaccination, including booster shot, at the time of exposure to a COVID-19 positive person during their contagious period; and (iii) have been in quarantine. The form also requires individuals to verify their (or their child’s or dependent’s) dates of quarantine, confirm that they have quarantined for five days following the last day of exposure to the COVID-19 positive person, and have remained asymptomatic for five days at the time of signing.

Affirmation of Isolation Form

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. Specifically, the form includes the attestation that the individual (or their child or dependent) “must isolate for the appropriate amount of time, depending upon hospitalization, length of symptoms and particular circumstances,  consistent with guidance issued by the NYSDOH, for at least five (5) days from the onset of COVID-19 symptoms OR from the date of the positive COVID-19 test if asymptomatic.”

Both forms specify that Day 1 of quarantine or isolation begins the day after the individual’s last day of exposure to the COVID-19 positive person (for quarantine) or after the individual became symptomatic or tested positive if asymptomatic (for isolation).

Additional information regarding the NYSDOH’s updated Isolation & Quarantine Guidance is available here.