Orleans County, NY

Positive COVID-19 Home Test Reporting Form

Please follow the manufactures directions to complete your at-home COVID-19 test.

Please use the form below to report a positive result from a COVID-19 test taken at home.  A new form must be completed for each household member who tests positive.  A picture of the test result must be taken within 15 minutes of the manufacturer’s directions processing end time. The name of the individual who was tested, the date and time the test was taken should be written legibly on the test. If there are any missing sections that are required on the form below, the form will be invalid. 

A photo image of your positive test result is REQUIRED.  Positive test results are required to be submitted within 24 hours of completing the at-home test. Do NOT submit this form if you tested negative. 

Please isolate immediately and you will receive a call from a case investigator regarding your positive test. Depending on our caseload, it may one to three days before you are called.   Please answer the phone so we can reduce the spread of COVID-19.  Thank you.

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