Return to Work/School Request Letter
If the Department of Health has contacted you regarding your status as a close contact to someone who has tested positive for COVID – 19 or if you have tested positive for Covid-19 you may request an employer letter. This is for individuals only – employers may not request a letter for their employee (s).
What type of letter?
*
Return to Work
Return to School
Are there multiple children needing letters in the home?
*
Yes
No
Enter Children information below:
*
Name:
*
First Name
Last Name
Date of Birth:
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Phone Number
*
-
Area Code
Phone Number
How would you like your letter delivered? You may selected both options if preferred.
*
personal email
home address
How would you like your letter delivered?
email
mailed
Individual's Email:
You must provide a personal email. Letters will not be sent to an employer.
Individual's Home Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
If known, please provide your DOH Case ID Number?
This number is 9 digits.
If known, Disease Intervention Specialist's Name:
Submit
Should be Empty: