Positive COVID-19 Home Test Reporting Form

Erie County Department of Health (ECDOH)

This form is for Erie County, NY residents ONLY

Please use this form to report your at-home performed COVID-19 positive test to the ECDOH. 

If you have tested positive for COVID 19, please review the information on the Isolation and Quarantine page for Isolation instructions. 

Fields with * are required fields. 

If yes, continue completing this form. 

Name
Address