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Employee COVID-19 Test Results Self-Attest

  1. Information

    Effective September 17, 2021, pursuant Contra Costa Health Services Order No. HO-COVID19-53, first responders are mandated to obtain weekly testing for COVID-19 or provide documentation of their fully vaccinated status. 

    Instructions for unvaccinated police officers: Complete the form below to record weekly COVID-19 testing results. If you have any questions, please contact Human Resources directly by emailing or calling (510) 215-4315.

  2. Employee Attest:

    I attest that I am providing accurate information about my test results. I hereby affirm that I have accurately and truthfully recorded the information above.  By completing and submitting the online version of the Employee COVID-19 Test Results Self-Attest Form, this signifies my signature.  

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