Sample of a dated form for traveling to Vermont below.
Instructions to business: Keep this form on file for 30 days. Original Available at:
Effective June 8th, 2020, Vermonters may travel outside of Vermont to counties across New England and New York that have a similar active COVID-19 caseload to Vermont and return without quarantining if they do so in a personal vehicle. Similarly, residents of other states who live in counties across New England and New York that have a similar active COVID-19 caseload to Vermont may enter the state for leisure travel without quarantining.
The State of Vermont has determined that any county with less than 400 active cases of COVID-19 per one million residents meets this criteria. The Agency will publish an updated map and list each Monday by 5 p.m. at accd.vermont.gov identifying quarantine and non-quarantine counties throughout New England and New York. Vermonters must remember to follow any travel restrictions and quarantine requirements for the states they plan to visit.
Residents from a non-quarantine county may travel to Vermont without quarantine restrictions if they travel directly to Vermont in their personal vehicle. This includes overnight travel, commuting for work, leisure visits and recreation. Travelers must register with Sara Alert upon arrival to Vermont to get two weeks of daily reminders to check for common symptoms of COVID-19. Travelers must remember to follow any travel restrictions and quarantine requirements in their home upon return.
After July 1st, the State of Vermont plans to re-evaluate this criteria to determine if it should be expanded or restricted based on current data. The State hopes more counties will be added over time as their active case counts improve and that the criteria may be expanded beyond 400 cases per million after July 1st and as circumstances allow.
Travelers, including Vermonters, that visit or are from a quarantine county must still quarantine for 14-days upon entrance into Vermont or quarantine for at least seven days upon entrance into Vermont and receive a negative COVID-19 test.
Commuter (day trip) traffic to and from Vermont by those who travel daily between Vermont and adjacent states including quarantine-required counties in those adjacent states is authorized for essential travel (e.g. essential work, healthcare, groceries) and currently authorized daily work, family visitation, or recreation. Travel to and from Vermont from outside the daily commuting area AND by those who do not travel to and from adjacent states daily is currently restricted and subject to all other travel restrictions.
Those participating in essential work or currently authorized work that requires an overnight stay may utilize the state’s lodging, camping and short-term rental properties if the individual self-certifies upon arrival that they are authorized to work in Vermont, have not been in contact with someone with COVID-19 in the past 24 hours, and have not experienced COVID-19-like symptoms in the past 24 hours including a fever above 100.4°F, chills, muscle pain, sore throat, headache or new loss of taste or smell.
Travelers may complete either: (i) a 14-day quarantine; or (ii) a 7-day quarantine followed by a negative test – in their home state and enter Vermont without further quarantine restrictions if they drive directly from their home via their personal vehicle.
Travelers may complete either: (i) a 14-day quarantine; or (ii) a 7-day quarantine followed by a negative test – in a Vermont lodging establishment regardless of destination origin or manner of travel (travelers must stay in their quarantine location for the duration of quarantine other than to travel to and from a test site).
For more information about how to quarantine, visit the Vermont Department of Health’s quarantine chart.
1. I certify that:
a. I have not left the state of Vermont for any reason except essential travel in the past 14 days; OR
b. I have completed a 14-day self-quarantine and have not left the state of Vermont since completing this quarantine; OR
c. I have been in a county in NY, RI, MA, ME, NH, or CT with fewer than 400 active COVID-19 cases per million, as set forth on the Vermont Agency of Commerce and Community Development’s website*, and I did not travel to Vermont by air or bus, and I have registered with the Vermont Department of Health’s Sara Alert system* and will provide updates to that system daily; OR
d. I am a critical worker as defined by the State of Vermont.
2. I also certify that I have not had close contact within the past 14 days with a person confirmed to have COVID-19.
3. I also certify that I do not currently, and have not had in the past 24 hours, any of the following symptoms:
• A fever above 100.4° F / 38° C, or felt feverish;
• Muscle pain;
• Sore throat;
• New loss of taste or smell.
4. I also certify that all persons in my care who are under the age of 18 or who are dependent on my care meet the criteria described in items 1–3 above. Please provide a list of the names of all such persons in your care.
5. I have read and understand this entire Certificate of Compliance and make the above certifications under the pains and penalties of perjury.
*For information related to completing this form, visit: accd.vermont.gov/coc Dated: in , Vermont.
PERSON 1 Signature: Printed Name: PERSON 2 (FROM SAME HOUSEHOLD; OPTIONAL) Signature: Printed Name: HOUSEHOLD CONTACT INFORMATION Address: Phone:
By Donald Perry 06/10/2020