Monroe County, NY Positive COVID-19 Home Test Reporting Form

This form is for voluntary reporting of POSITIVE home test results. The Monroe County Department of Public Health will not contact you.

Please do not use this form if:

If your employer/school requires documentation of your isolation, please use the New York State Department of Health AFFIRMATION OF ISOLATION form. This self-reporting form serves as your Order of isolation and can be submitted for New York Paid Family Leave COVID-19 claims.

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