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.

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Photo of Evandro Gigante Evandro Gigante

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 and counsels clients through a variety of labor and employment matters, including allegations of…

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 and counsels clients through a variety of labor and employment matters, including allegations of race, gender, national origin, disability and religious discrimination, sexual harassment, wrongful discharge, defamation and breach of contract. Evandro also counsels employers through reductions-in-force and advises clients on restrictive covenant issues, such as confidentiality, non-compete and non-solicit agreements.

With a focus on discrimination and harassment matters, Evandro has extensive experience representing clients before federal and state courts. He has tried cases in court and before arbitrators and routinely represents clients before administrative agencies such as the Equal Employment Opportunity Commission, as well as state and local human rights commissions.

Photo of Laura Fant Laura Fant

Laura Fant is a special employment law counsel in the Labor & Employment Law Department and co-administrative leader of the Counseling, Training & Pay Equity Practice Group. Her practice is dedicated to providing clients with practical solutions to common (and uncommon) employment concerns…

Laura Fant is a special employment law counsel in the Labor & Employment Law Department and co-administrative leader of the Counseling, Training & Pay Equity Practice Group. Her practice is dedicated to providing clients with practical solutions to common (and uncommon) employment concerns, with a focus on legal compliance, risk management and mitigation strategies, and workplace culture considerations.

Laura regularly counsels clients across numerous industries on a wide variety of employment matters involving recruitment and hiring, employee leave and reasonable accommodation issues, performance management, and termination of employment . She also advises on preparing, implementing and enforcing employment and separation agreements, employee handbooks and company policies, as well as provides training on topics including discrimination and harassment in the workplace. Laura is a frequent contributor to Proskauer’s Law and the Workplace blog and The Proskauer Brief podcast.

Photo of Raymond Arroyo Raymond Arroyo

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

During his time at Proskauer, Raymond has focused on a wide range of employment matters, including employment discrimination litigation, labor/management relations, and policies, handbooks…

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

During his time at Proskauer, Raymond has focused on a wide range of employment matters, including employment discrimination litigation, labor/management relations, and policies, handbooks and training, among others. Raymond has gained experience across a wide variety of industries including financial services, educational institutions, and sports.

Raymond earned his J.D. from Columbia Law School. While at Columbia, Raymond worked at the Center for Public Research and Leadership as a graduate assistant, providing consulting and strategic advice to educational institutions and organizations.  Raymond was also a staff editor for the Columbia Journal of Race and Law.

Prior to his legal career, Raymond was a Teach for America corps member and taught middle school in New York City.