Frequently Requested Information & Forms
Frequently Requested Information and 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.
