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   Toll Free: 866.349.3739    Contact Us
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New River Community and Technical College
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New River Community and Technical College
  • Home
  • Current Students
    • Academic Calendar
    • Bookstore
    • Course Schedules
    • Forms
    • Find My Username
    • Offices & Departments
      • Academics
      • Counseling
      • Financial Aid Office
      • Registrar’s Office
      • Student Success Center
    • Resources
      • WV Public WiFi Locations
      • Student Video Resources
      • Career Services
      • Counseling
      • Delays & Closings
      • Disability Needs
      • Emergency Alert System
      • Graduation
      • Information Technology Services
      • Library Services
      • My New River Portal
      • Program Advising
      • Student Clubs & Organizations
      • Student Handbook
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      • Testing
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    • Transfer Agreements
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  • Future Students
    • Ready to Apply
      • Admissions
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      • EDGE Credit
    • Online Student Orientation
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New River Community and Technical College

Quarantine Certification Form

CERTIFICATION OF ILLNESS or QUARANTINE

  • I (Your Name Above), a student/employee of New River Community and Technical College, do, by my signature below, certify that:
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • I decided to self-quarantine due to this condition, from

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • New River Community and Technical College is following the guidance of the Centers for Disease Control regarding steps to diminish the spread of COVID-19/coronavirus. The CDC is encouraging all persons who have cold/flu-like symptoms to self-isolate until the illness has passed. (See guidance on health care at https://www.newriver.edu/coronavirus/ ) If you are sick, please stay home. As the CDC Guidance explains, any person with fever or any difficulty or pain in breathing should contact their doctor immediately. It is always okay for anyone who is sick to consult their doctor, even if the symptoms are mild. The CDC hopes that self-isolation strategies will slow the spread of coronavirus around the country. If you are ill, stay home and contact your supervisor regarding your absence and the submission of sick leave in KRONOS.

    The CDC has urged colleges and universities to modify, where possible, policies that make it difficult to follow the recommendation of self-isolation. In support of that guidance, New River Community and Technical College has adopted a CERTIFICATION OF ILLNESS or QUARANTINE form which students/employees can use during this period in lieu of medical documentation when absent due to illness.

    This form can also be used if you need to self-quarantine for a specific coronavirus risk. Due to the extreme communicability of coronavirus, the CDC is also encouraging certain persons with no current symptoms of illness to nevertheless self-quarantine. Therefore:
    1. 1. If a student/employee is confirmed to have been: a) directly exposed to a known coronavirus case, or b) traveled to a location considered “level 3” or higher by the CDC, or c) traveled to a place where health authorities are formally requesting self- quarantines to be used, they should avoid coming to campus and advise their instructor(s) or supervisor that they will self-quarantine, and use the CERTIFICATION form.
    2. 2. The self-quarantine would continue 14 calendar days away from campus without requiring any medical documentation; only the CERTIFICATION is required. Staff may apply either sick leave or annual leave.
    3. 3. If concerning an employee, and the nature of an employee’s work lends itself to working remotely, they may discuss that with their supervisor, who may ask the area Vice President to approve or deny that request. Faculty would be expected to follow the Academic Affairs Contingency Plan.
    4. 4. Students will communicate with instructors to develop alternate plans for course work completion if necessary.
    5. 5. No employee would be eligible for catastrophic leave in these cases. If the employee does not have enough leave to cover their time off, and they cannot telework, they would not be paid.
    Students/Employees are advised that the use of this form constitutes a legal certification that they genuinely isolated themselves for the period that they designate. Completion of this form by persons who did not engage in self-isolation due to flu-symptoms or coronavirus risk is a fraud on the College.
  • That as a part of my self-quarantine I have isolated myself during this period of time and have only left my residence when absolutely essential, such as doctor visits;

    That I submit this Certification of Illness in lieu of a physician’s note as to my absence from school/work at New River Community and Technical College;

    That I fully understand that submission of this Certification of Illness or Quarantine under false pretenses (which would include failure to genuinely self-isolate during the listed times) would constitute a fraud upon the College.
  • This certification of illness or quarantine is only accepted as valid by the College to document an absence of up to two calendar weeks. A physician’s note is required for absences of greater length. Special circumstances may be reviewed by HR.
Last Updated On: 25th August, 2020
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New River CTC News

New River CTC announces fall 2020 President’s and Dean’s List students

New River CTC announces fall 2020 President’s and Dean’s List students

January 14, 2021
Anderson to offer Hero’s Journey workshop

Anderson to offer Hero’s Journey workshop

January 11, 2021
Anderson to guide Fantastic Ekphrastic workshop through New River CTC

Anderson to guide Fantastic Ekphrastic workshop through New River CTC

January 04, 2021

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  • Beaver
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