June 30, 2022

Volume XII, Number 181

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New York State Department of Health Provides Self-Attesting Quarantine and Isolation Forms for COVID-19 Quarantine Leave Law Eligibility

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.

© 2022 Proskauer Rose LLP. National Law Review, Volume XII, Number 37
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About this Author

Evandro Gigante Labor and Employment Lawyer Proskauer Rose Law FIrm
Partner

Evandro Gigante is a partner in the Labor & Employment Law Department and co-head of the Employment Litigation & Arbitration group and the Hiring & Terminations group. He represents clients through a variety of labor and employment matters, including allegations of sexual harassment, race, gender, national origin, disability and religious discrimination. Evandro also counsels employers through reductions-in-force, employee relations issues and other sensitive employment matters.

With a focus on discrimination and harassment claims,...

212.969.3132
Laura M. Fant, Labor & Employment Attorney, Proskauer Law Firm
Associate

Laura M. Fant is an Associate in the Labor & Employment Department, resident in the New York office. She is a member of the Accessibility and Accommodations Practice Group, and frequently counsels on matters involving the Americans with Disabilities Act (ADA) and state public accommodation law, as well as disability accommodation in the workplace. She has experience conducting accessibility audits and providing ADA and accessibility training for clients in a variety of sectors, including retail, sports, and not-for-profit. Her practice also focuses on wage and hour...

212-969-3631
Law Clerk

Raymond Arroyo is a law clerk in the Labor Department and a member of the Employment Litigation & Arbitration Group.

212.969.3041
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