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COVID-19 Test Self Reporting Portal

  1. If you are a Brookline resident and have tested positive for COVID-19 using a home test kit (e.g., BinaxNOW, iHealth), please submit the following form to the Brookline Public Health Department. The Town of Brookline respects your right to privacy and confidentiality. By filling out this form you are consenting to the collection, processing, and use of the information you provide.

  2. What is your gender identity?*
  3. What is your race? (Mark all that apply)*
  4. Are you Hispanic, Latinx, or of Spanish origin*
  5. Agreement
  6. If you or a member of your household tested positive for COVID-19, that person should stay home, isolate away from others in the household if possible, and only leave the home for urgent medical appointments. Please notify any close contacts who may have been exposed so that they can get tested or quarantine per CDC guidelines. For more detailed information regarding isolation and quarantine, please visit You may call the state 2-1-1 line or visit for COVID-19 questions not specific to the Town of Brookline. 

    If you have additional questions, you may call the Brookline Public Health Department COVID-19 Case Investigator at (617) 730-2324. If we are unavailable, please leave a message and we will return your call as soon as possible. Thank you very much for helping to keep Massachusetts safe.

  7. Leave This Blank:

  8. This field is not part of the form submission.