Two forms: You can do them from here, or we also will have some at the office for you if that's easier.
If you - or anyone in your household - have/has traveled to, through,
or from any of the following states or out of the country in the last two weeks, please let us
know and we can postpone your appointment for two weeks
OR DO THE FOLLOWING:
For travelers who were out-of-state for more than 24 hours:
- Travelers must obtain a COVID test within three days of departure, prior to arrival in New York.
- The traveler must, upon arrival in New York, quarantine for three days.
- On day 4 of their quarantine, the traveler must obtain another COVID test. If both tests come back negative, the traveler may exit quarantine early upon receipt of the second negative diagnostic test:
Alabama Missouri Wisconsin
Alaska Mississippi West Virginia
Arkansas Montana Wyoming
Arizona North Carolina California
Colorado North Dakota
Delaware North Carolina
Florida Nebraska
Georgia New Mexico
Guam Nevada
Iowa Ohio
Idaho Oklahoma
Illinois Puerto Rico
Indiana Rhode Island
Kansas South Carolina
Kentucky South Dakota
Louisiana Tennessee
Maryland Texas
Michigan Utah
Minnesota Virginia
........................................................................................................................................................................................................................ Read above, copy/paste, print, sign and send or bring this signature section below, OR if you would like to come in, we have this in the office too.
I, _______________________________________ confirm that I have read and am abiding by the 11/15/2020 travel restrictions.
Parent/ Guardian Name (if applicable)
________________________________________________/______________________
(Parent/ Guardian Signature) DATE
...............................
