Pennsylvania Employee Authorization to Disclose COVID-19 Coronavirus Test Result

State:
Multi-State
Control #:
US-CVD-004
Format:
Word; 
Rich Text
43 downloads

Description

An employee who tests positive for the COVID-19 coronavirus may authorize his or her employer to disclose the diagnosis employees at the worksite and to others, i.e., clients, visitors or customers. The signing of an authorization is necessary due to the privacy guaranteed by federal law including the Americans with Disabilities Act and the Family Medical Leave Act. Signing the authorization is voluntary and not required.

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Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

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If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

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We protect your documents and personal data by following strict security and privacy standards.

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Pennsylvania Employee Authorization to Disclose COVID-19 Coronavirus Test Result