Complete this form if you or your child had close contact with an individual infected with SARS-CoV-2 virus (COVID-19), and have met criteria for release from quarantine. Upon completion, you will receive a document that may be used as if it was a Release From Quarantine Order issued by the Saratoga County Commissioner of Public Health.

Person Completing This Form

Individual Being Quarantined


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. In addition, SCPHS has implemented procedures to safeguard the integrity of its information technology assets, including, but not limited to, authentication, monitoring, auditing, and encryption. These security procedures have been integrated into the design, implementation, and day-to-day operations of this website as part of our continuing commitment to the security of electronic content as well as the electronic transmission of 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.

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