New York State Department of Health Forms

299
total templates

Documents

299

OCA Official Form 960 "Authorization to Release Health Information Pursuant to Hipaa" - New York

Rate (4.8 / 5) 18 votes
Size: 62 KB
2 pages

This is a legal document signed by a patient that gives consent to the release of health information within the state of New York.

Form DOH-4444 "Self-declaration of Income" - New York

Rate (4.5 / 5) 66 votes
Size: 20 KB
1 page

This is one of the documents you need to fill out when applying for Public Health Insurance Programs in the state of New York.

Form DOH-44 "Application for a Permit for a Public Gathering" - New York

Rate (4.7 / 5) 35 votes
Size: 230 KB
6 pages

Form DOH-30 "Adoptee Registration Form" - New York

Rate (4.6 / 5) 22 votes
Size: 1 MB
2 pages

Form DOH-80 "Notice of Course Cancellation" - New York

Rate (4.7 / 5) 18 votes
Size: 11 KB
1 page

Form DOH-89 "Certified Class List for Ancillary EMS Training Courses" - New York

Rate (4.8 / 5) 42 votes
Size: 44 KB
2 pages

Form DOH-65 "Application for Emergency Medical Services Certification" - New York

Rate (4.4 / 5) 18 votes
Size: 42 KB
2 pages

Form DOH-79 "Students Ineligible to Take the State Certifying Examination" - New York

Rate (4.8 / 5) 16 votes
Size: 60 KB
2 pages

Form DOH-372 "Application for Radiologic Technologist Licensure" - New York

Rate (4.4 / 5) 9 votes
Size: 389 KB
3 pages

Form DOH-348 "Application for Approval of Plans for Public Water Supply Improvement" - New York

Rate (4.8 / 5) 19 votes
Size: 115 KB
1 page

Form DOH-799 "Wic Medical Referral Form" - New York

Rate (4.6 / 5) 97 votes
Size: 47 KB
2 pages

Form DOH-352 "Application for Renewal of Certification Water System Operator" - New York

Rate (4.5 / 5) 14 votes
Size: 40 KB
2 pages

Form DOH-206 "Application for EMS Operating Certificate" - New York

Rate (4.7 / 5) 19 votes
Size: 147 KB
3 pages

Form DOH-367 "Children's Camp Facility and Staff Description" - New York

Rate (4.7 / 5) 58 votes
Size: 79 KB
2 pages

Form DOH-350 "Application for Certificate of Waiver From Disinfection Requirements" - New York

Rate (4.3 / 5) 14 votes
Size: 66 KB
2 pages

Form DOH-389 "Confidential Case Report" - New York

Rate (4.6 / 5) 19 votes
Size: 74 KB
1 page

Form DOH-359 "Annual Report on Violations of Watershed Rules and Regulations" - New York

Rate (4.5 / 5) 14 votes
Size: 190 KB
2 pages

Form DOH-166 "Controlled Substance Inventory Form" - New York

Rate (4.5 / 5) 12 votes
Size: 50 KB
1 page

Form DOH-695 "Screen Form" - New York

Rate (4.3 / 5) 89 votes
Size: 91 KB
7 pages

Form DOH-132 "Wic Medical Referral Form for Infants and Children" - New York

Rate (4.3 / 5) 71 votes
Size: 447 KB
3 pages

Form DOH-349 "Application for Certificate of Approval for Bottled or Bulk Water Facilities" - New York

Rate (4.7 / 5) 14 votes
Size: 1 MB
1 page

Form DOH-694 "Hospital and Community Patient Review Instrument (Hc-Pri)" - New York

Rate (4.8 / 5) 58 votes
Size: 42 KB
4 pages

Form DOH-360 "Water Systems Operation Report - Microbiological Sample Results" - New York

Rate (4.6 / 5) 21 votes
Size: 85 KB
2 pages

Form DOH-485 "Workers' Compensation Preferred Provider Organization (Ppo) Application" - New York

Rate (4.3 / 5) 66 votes
Size: 57 KB
4 pages

Form DOH-794 "Regulatory Compliance Statement" - New York

Rate (4.7 / 5) 48 votes
Size: 19 KB
2 pages

Form DOH-347 "Application for Approval of Backflow Prevention Devices" - New York

Rate (4.6 / 5) 23 votes
Size: 10 KB
1 page

Instructions for Form DOH-743 "Instructor Information Sheet" - New York

Rate (4.7 / 5) 10 votes
Size: 14 KB
1 page

Form DOH-3867 "Complaint Form" - New York

Rate (4.6 / 5) 50 votes
Size: 310 KB
4 pages

Form DOH-3848 "Semi-annual Controlled Substance Inventory Form for EMS Agencies" - New York

Rate (4.8 / 5) 8 votes
Size: 1 MB
2 pages

Form DOH-4275 "Application for Registration to Accept Home Generated Sharps for Safe Disposal" - New York

Rate (4.4 / 5) 22 votes
Size: 1 MB
6 pages

Form DOH-4380 "Mail-In Application for Copy of Birth Certificate" - New York

Rate (4.6 / 5) 36 votes
Size: 390 KB
2 pages

Form DOH-2340 "Request for Approval of Disposal/Destruction of Controlled Substances" - New York

Rate (4.3 / 5) 12 votes
Size: 485 KB
1 page

Formulario LS223S "Formulario De Queja Sobre Normas Laborales" - New York (Spanish)

Rate (4.6 / 5) 49 votes
Size: 235 KB
8 pages

Form DOH-2094 "Loss of Controlled Substances Report" - New York

Rate (4.3 / 5) 23 votes
Size: 1 MB
2 pages

Form DOH-5273 "Application for Registration as a Controlled Substance Agent for a Facility Certified for Euthanasia of Animals" - New York

Rate (4.5 / 5) 16 votes
Size: 508 KB
2 pages

Form DOH-2794 "Application for the Uninsured Care Programs" - New York

Rate (4.7 / 5) 22 votes
Size: 72 KB
5 pages

Form DOH-4332 "Application for Initial Certification as a Euthanasia Technician for Animals" - New York

Rate (4.6 / 5) 16 votes
Size: 59 KB
2 pages

Form DOH-4333 "Application for Registration of an Incorporated Society or Municipal Animal Control Facility to Euthanize Animals" - New York

Rate (4.7 / 5) 59 votes
Size: 97 KB
2 pages

Form DOH-5069 "Access to Services in Your Language: Complaint Form" - New York (Bengali)

Rate (4.8 / 5) 27 votes
Size: 227 KB
1 page