Self Attested Return to Work Letter
By signing this document, I verify that I have completed the necessary isolation or quarantine periods as
recommended by the CDC and have been symptom-free for the appropriate number of days as
required below, and that the information reported below is correct.
Therefore, I can be released from isolation or quarantine and may resume work-related activities.
By signing this document, I will abide by my employer's infection control policies and any other
requirements pursuant to any executive orders and other applicable state laws and rules.
____________________________________________________________________________________
Print Name
Employees Returning from Isolation after Testing Positive for COVID-19 OR Returning
from Quarantine After Exposure to a Confirmed COVID-19 Case
Date of Symptom Onset OR Specimen Collection Date if Positive Test (if
asymptomatic) OR Date of Last Exposure to COVID-19 Confirmed Case. (Day 0)
_______________________________________
End of Isolation Period OR End of Quarantine period if asymptomatic and no positive
test. (Day 6)
_______________________________________
____________________________________________________________
Signature
____________________
Date
*Individuals should not end their isolation or quarantine until their symptoms are improving and they
are fever-free for 24 hours without fever-reducing medication.
This document summarizes the CDC’s guidelines for isolation and quarantine to help employees
and employers assess when an individual can return to work after a confirmed case of COVID-
19 or after close contact with a confirmed case of COVID-19. Neither the Centers for Disease
Control and Prevention (CDC), Occupational Safety and Health Administration (OSHA), or the
Equal Employment Opportunity Commission (EEOC) recommend that employers require
employees to obtain a note from a doctor or other health care provider before returning to
work after a COVID-19 diagnosis or close contact. Instead, employers are urged to develop
policies that align with these guidelines and recommendations in regards to employee return to
the workplace after a confirmed case of COVID-19 or a close contact with a confirmed case of
COVID-19. Employees are cautioned that this document is general guidance, and employees
should consult with their individual employers for policies applicable to their situation.
Guidelines and Recommendations
Positive Cases
Individuals who have tested positive for COVID-19 should isolate for 5 days after onset of symptoms
(onset day is Day 0), or 5 days after the date of specimen collection of positive test if no symptoms are
present (specimen collection date is Day 0). If an individual is fever-free for 24 hours (without the use of
fever-reducing medication) and their symptoms are improving after 5 days, they are released from
isolation (on Day 6) but need to continue to wear a well-fitting mask for the next 5 days when around
others, including at home.
Close Contacts
Individuals who have been in close contact with a confirmed case of COVID-19 should follow the
quarantine guidelines below depending on whether they have been vaccinated or have had a confirmed
case of COVID-19 within the past 90 days.
If an individual had a confirmed case of COVID-19 within the past 90 days, confirmed with a
viral test (antigen or PCR), OR is up-to-date on recommended COVID-19 vaccinations, including
booster doses, they:
• Do not need to quarantine if they do not have any COVID-19-like symptoms, but should wear a
mask around others for 10 days from the date of last close contact, and test 5 days after the
date of last exposure.
• Should watch for symptoms until 10 days after date of last close contact with someone with
COVID-19. If COVID-19-like symptoms develop, they should immediately isolate from others
until a negative test result confirms that symptoms are not caused by COVID-19.
• Those with household or other close contact exposures may consider testing a second time if
the first test is negative two days after the date of the specimen from the first negative test.
If an individual is NOT up-to-date on recommended COVID-19 vaccination, they:
• Should stay home and quarantine for 5 days, and continue to wear a mask around others for an
additional 5 days and test 5 days after the date of last exposure (if test is positive, continue to
isolate until viral test is negative (antigen or PCR)).
• Watch for symptoms until 10 days after the last close contact with someone with COVID-19.
• If COVID-19 symptoms develop, should immediately isolate at home until a negative test result
confirms that symptoms are not caused by COVID-19. Those with household or other close
contact exposures may consider testing a second time if the first test is negative two days after
the date of the specimen from the first negative test.
Regardless of vaccination status, individuals following release from 5 days of
isolation/quarantine, should do the following:
• Avoid people who are immunocompromised or at high risk for severe disease, and nursing
homes and other high-risk settings, at least until 10 days after onset date or specimen collection
date if asymptomatic, or after last close contact with someone with COVID-19.
• • Not go to places where they are unable to wear a mask, such as restaurants and some gyms,
and avoid being around others at home and at work until 10 days after onset date or specimen
collection date if asymptomatic, or after last close contact with someone with COVID-19.
Healthcare workers, those with severe COVID-19 illness, immunocompromised, school-aged
children or children or staff in daycare settings may be subject to additional or different
requirements for purposes of return to work, school or daycare. Please visit the following
websites for additional guidance:
• Severely ill with COVID-19: isolate for at least 10 days and Consult your doctor before ending
isolation.
• Healthcare worker
• Immunocompromised: People with Certain Medical Conditions | CDC
• School-aged children
• Daycare:
