If you or someone you know tests positive for COVID-19, it's important that you know the steps to follow to protect yourself and those around you, and to reduce the spread of the virus in your community. These precautions include isolating, wearing a mask, and avoiding contact with people who are at high risk of getting sick.
This form may be used as if it were an individual Isolation Order. Nassau County Department of Health or New York State Department of Health may contact you for additional information. This Affirmation Form will contain your Isolation start and end date, as you indicate, based on your particular circumstances, in accordance with guidance from the New York State Department of Health which is following the Centers for Disease Control and Prevention’s (CDC) guidance (see above link).
This form may also be used for Isolation Release or for New York Paid Family Leave COVID-19 claims as if it were an individual Order for Isolation issued by New York State Department of Health or Nassau County Commissioner of Health.