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Child & Adolescent Health Examination Form (English)

    https://www.schools.nyc.gov/docs/default-source/default-document-library/ch205-child-adolescent-health-examination-form-english
    Child & Adolescent Health Examination Form (English)

Health Requirements to Attend School - web

    https://www.schools.nyc.gov/school-life/health-and-wellness/health-requirements-to-attend-school
    E-12s Eye Report and Recommendation Form available in: English Please return your completed Eye Report and Recommendation form to your school nurse. You can also …

New York State Office of Children and Family Services

    https://ocfs.ny.gov/main/Forms/Day_Care/OCFS-LDSS-4433.dot
    To Be Completed By Licensed Physician, Physician Assistant or Nurse Practitioner. Name of Child: Date of Birth: Date of Examination: Immunizations required for entry into day …

OCFS-6004 (08/2019) FRONT NEW YORK STATE …

    https://ocfs.ny.gov/forms/ocfs/OCFS-6004.pdf
    Only a health care provider (physician, physician assistant, nurse practitioner) may complete/sign the Medical Status section. A registered nurse is NOT authorized to sign …

ACS - Eligibility - New York City

    https://www.nyc.gov/site/acs/early-care/forms.page
    Child Care Application This form is for families who are applying for child care for the first time. Child Care Application - Supplemental Forms These forms are for families who …

Child Care - NYC Health - New York City

    https://www.nyc.gov/site/doh/services/child-care.page
    When deciding where to place your child, you should focus on your family’s specific needs. Be sure to make an informed decision based on the type of program and its performance …

Child Care School Based - NYC Health - New York City

    https://nyc.gov/site/doh/business/permits-and-licenses/child-care-school-based.page
    If you are starting a new program, you must submit a Notice of Filing to the Health Department, which must include at least one of the following Department of Education …

NEW YORK STATE OFFICE OF CHILDREN AND …

    https://ocfs.ny.gov/forms/ldss/OCFS-LDSS-7020.pdf
    Medical Statement for each child must have been completed within the 12-months preceding the date of enrollment. Form OCFS-LDSS-4433, Child in Care Medical …

Child Care Center Based - NYC Health - New York City

    https://www.nyc.gov/site/doh/business/permits-and-licenses/child-care-center-based.page
    If you are starting a new program, you must attend a pre-permit orientation (check the box next to “Group Child Care and Summer Camp Orientation Sessions”, then click …

Forms - New York State Department of Health

    https://www.health.ny.gov/forms/
    General Forms Health Care Coverage Health Insurance Application (PDF) - Some applicants are required to apply for Medicare as a condition of eligibility for Medicaid. …



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