During an infectious disease outbreak, it is critical that essential healthcare workers, visitors, vendors, volunteers, and contractors do not report to any Garnet Health facilities while ill and / or experiencing the following symptoms: fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, shortness of breath, loss of taste or smell, diarrhea, or fatigue.  If you are a healthcare volunteer of Garnet Health and have any symptoms contact the Volunteer office, do not report to work and please call the Occupational Health Staff Medical Evaluation line (845) 333-2066 to discuss the next steps.  

For the safety of the Garnet Health community, we require all to wear a mask, clean your hands and social distance.

By agreeing you attest to the fact that you Do Not have any of the above mentioned diagnoses or symptoms.


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* 1. Are you experiencing or have you recently experienced any of the above symptoms?

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* 2. If yes, please call Occupational Health (x2066) and sign/date below. 

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* 3. If no, please sign and date below.