Fill and Sign United States Legal Forms

This Form is used for requesting the Influenza Vaccine in the state of New York.

This form is used for reporting communicable diseases related to rabies in New York. It is a required document for tracking and preventing the spread of the disease.

This form is used for the Health-Related Legal Services Program Attestation in New York. It is a document that verifies the eligibility and participation of individuals in the program.

This form is used for registering biological siblings in the Adoption Information Registry in New York.

This form is used for determining medical eligibility for uninsured care programs in New York. It helps individuals without health insurance access necessary medical services.

This form is used for applying to the Uninsured Care Program for HIV in New York. It is written in Spanish.

This form is used for applying for the Uninsured Care Programs in New York. It is specifically designed for French-speaking individuals.

This form is used for applying for the Uninsured Care Programs in New York, but it is specifically translated into Haitian Creole.

This Form is used for applying for New York's Uninsured Care Programs specifically designed for Italian residents who do not have health insurance coverage.

This document is used for practitioners in New York to establish an agreement with patients for Adap Plus services.

This document explains the Medicaid Spenddown/Surplus program in New York. It outlines how individuals can qualify for Medicaid by spending down their excess income or assets.

This form is used for creating a legally binding agreement between a home care provider and a client in New York. It outlines the services to be provided, payment terms, and responsibilities of both parties.

This document is used for the Practitioner Specialty Provider Agreement for the Pre-exposure Prophylaxis Assistance Program (Prep-Ap) in New York. It outlines the agreement between practitioners and the program for providing specialized medical services related to HIV prevention and treatment.

This document is a specialty provider agreement for healthcare providers in New York. It outlines the terms and conditions between the provider and the organization they are contracting with. This agreement helps ensure that both parties are aware of their rights and responsibilities.

This Form is used for authorizing the release of health information and confidential HIV-related information in New York, but in French.

This form is used to authorize the release of health information and confidential HIV-related information in New York for Italian residents.

This document is used for authorizing the release of health information, including alcohol/drug treatment, mental health information, and HIV/AIDS-related information. It is specific to New York and is available in Korean.

This form is used for authorizing the release of health information, including alcohol/drug treatment, mental health information, and confidential HIV/AIDS-related information in New York. The form is available in Haitian Creole.

This document is used for authorization to release health information, including alcohol/drug treatment and mental health information, as well as confidential HIV/AIDS-related information in New York. It is available in French.

This form is used for authorizing the release of health information, including alcohol/drug treatment, mental health information, and confidential HIV/AIDS-related information. It is specific to the state of New York and has an Italian version available.

This Form is used for filing a complaint about a suspected violation of Article 27f in New York. The form is available in French (DOH-2865FR).

This form is used for authorizing the disclosure of health information, including information about alcohol/drug treatments and mental health, as well as confidential information related to HIV/AIDS. This form is specific to New York and is in Spanish.

This Form is used for reporting complaints related to the alleged violation of Article 27f in New York, specifically for Italian-speaking individuals.

This form is used for reporting complaints related to alleged violations of Article 27f in New York.

This form is used to apply for registration in the Expanded Syringe Access Program (ESAP) in New York. ESAP is a program that allows registered pharmacies and healthcare professionals to distribute sterile syringes and needles to individuals without a prescription.

This form is used for authorizing the release of health information and confidential HIV-related information in New York, with a Russian translation.

This form is used for authorizing the release of health information, including alcohol/drug treatment and mental health information, as well as confidential HIV/AIDS-related information in New York. It is available in Russian.

This Form is used for applying for a con or convention in New York. It provides instructions on how to fill out the application correctly.

This form is used for prospective Children's Camp Directors in New York to provide a certified statement.

This form is used for declaring additional staff qualifications for children's camps in New York.