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Report a Positive Self-Test

Schenectady County residents can use this form to tell Schenectady County Public Health Services (SCPHS) about a POSITIVE COVID-19 self-test. The self-test must be authorized by the Food and Drug Administration (FDA). A list of authorized self-test can be found here

Negative results from self tests do NOT need to be reported. Self-tests can NOT be used for release from quarantine. 

This form should NOT be used to report results of a test obtained or performed at or through a doctor's office, clinic, hospital, laboratory, pharmacy, school, or any testing site or program operated by SCPHS. 

After submitting this form please view the information at www.schenectadycounty.com/COVID19 and take the actions appropriate to your particular circumstances.

If additional information is needed, Schenectady County Public Health Services will contact you.

 

First name of the person who self-tested positive with COVID19
Last name of person with the positive self test
If asymptomatic leave blank.
Home Address of the person with a positive self-test
Please enter the home address of the person with a positive self-test
Telephone number where you can be reached
Does the person with the positive self-test:

SCPHS is strongly committed to protecting personal information collected through this website against unauthorized access, use, or disclosure. Consequently, SCPHS limits employee access to personal information collected through this website to only those employees who need access to the information in the performance of their official duties. Employees who have access to this information follow appropriate procedures in connection with any disclosures of personal information.

SCPHS may collect or disclose personal information without consent if the collection or disclosure is: (1) necessary to perform the statutory duties of the SCPHS, or necessary for SCPHS to operate a program authorized by law, or authorized by state or federal statute or regulation; (2) made pursuant to a court order or by law; (3) for the purpose of validating the identity of the user; or (4) of information to be used solely for statistical purposes that is in a form that cannot be used to identify any particular person.