Tri-Town Frequently Requested Information & Forms

Assisted Living

Forms and other information related to assisted living facilities and related issues in New York State

Communicable Disease Reporting Form

The NYS Dept. of Health form for reporting communicable diseases

Dental Health Educational Materials and Publications

Order form

Child Health Plus

Information about Child Health Plus insurance program

Diabetes

Order form for a range of information about managing diabetes

Elderly Pharmaceutical Insurance Coverage

(EPIC)

Family Health Plus Application

This application can be used to apply for Child Health Plus, Family Health Plus, Medicaid and the Family Planning Benefit Program

Family Planning Benefit Program Materials

Order form

Health Care Proxy Form

Appoint someone you trust to make health care decisions for you if you lose the ability to make decisions yourself

Healthy New York Program

Information on this health insurance program designed to assist small business owners, their employees and their employees’ families as well as uninsured sole proprietors and workers whose employers do not provide health insurance

HIV Uninsured Care Programs

A program for free health care (HIV Drugs, Primary Care, Home Care, and APIC) for New York State residents with HIV infection who are uninsured or underinsured

Medicaid Application

This one application can be used to apply for Child Health Plus, Family Health Plus, Medicaid and the Family Planning Benefit Program

Patient Bill of Rights

Your rights as a hospital patient in New York State