This is a legal document signed by a patient that gives consent to the release of health information within the state of New York.
This is a form used by the residents of New York to request a specific mode of transportation which is necessary because they are unable to use public transportation to go to school, places of worship, stores, etc.
Form DOH-4359 "Physician's Order for Personal Care/Consumer Directed Personal Assistance Services" - New York
This form can be used by individuals who would like to apply for certain types of assistance in the state of New York, such as home care, help with skilled or personal tasks, housekeeping, etc.
This is one of the documents you need to fill out when applying for Public Health Insurance Programs in the state of New York.