Get Ny Self Attestation Affirmation Of Isolation - Oneida County 2022-2025

The NY Self Attestation Affirmation Of Isolation form serves as crucial legal documentation for individuals who have tested positive for COVID-19. This guide provides a step-by-step approach to accurately complete the form online, ensuring compliance with New York State guidelines.

Follow the steps to successfully fill out the form.

1. Click the ‘Get Form’ button to access the affirmation form and open it in your browser or document editor.
2. In the first section, print your name clearly in the space provided. This identifies the individual completing the form.
3. Indicate the dates of isolation by entering the start date and the end date in the designated fields. Ensure these dates are accurate based on isolation guidance.
4. Next, affirm your isolation period by acknowledging that you or your child remained isolated for at least five days from the onset of symptoms or the date of the positive test.
5. Confirm your current health status by indicating if you or your child is symptom-free or if symptoms have improved, as well as ensuring that there has been a 24-hour fever-free period without medications.
6. Provide the name and date of birth of the individual who tested positive for COVID-19 in the specified spaces.
7. Include the date of specimen collection for the positive test and the symptom onset date if they occurred earlier than the specimen collection date.
8. Affirm the information by signing the form and entering today’s date. Remember that your signature is a declaration of the truthfulness of the information provided.
9. Review the completed form to ensure all fields are accurate and filled. Once finalized, save any changes made during the completion process.
10. You can then download, print, or share the completed form as needed for your records or for any claims related to New York Paid Family Leave.

Complete your documents online today to ensure your compliance and protect your rights.