New York State Department of Health Forms

This form is used for the engineer's certification of technical requirements for the design of ultraviolet (UV) facilities for disinfection of a public water supply in New York.

This form is used for applying for a specific waiver for the installation or replacement of residential on-site water supply systems in New York.

This form is used for filing an annual report on violations of watershed rules and regulations in New York.

This form is used for reporting monthly operations related to bulk water in New York.

This form is used for submitting a Water System Operation Report by public water systems in New York that treat water with chlorine and/or fluoride. It provides instructions for completing the form and reporting the necessary information.

This form is used for reporting the monthly operation of bottled water facilities in the state of New York.

This form is used for recording percolation test data in New York. It helps to assess the ability of soil to absorb water.

This form is used for conducting a Level 1 assessment for the Total Coliform Rule in New York. It helps ensure the safety of drinking water.

This form is used for reporting the microbiological sample results of water systems operations in New York.

This form is used for reporting the operation of water systems in New York that treat with chlorine and/or ultraviolet radiation.

This form is used for ordering a radon detector in New York.

This form is used for requesting a radon detector in New York.

This form is used for the Sparcs Data Agreement Notification in New York. It is a notification form related to data agreements in the healthcare field.

This form is used for conducting an environmental assessment of water systems in healthcare settings in New York. It helps in evaluating the quality and safety of water used in healthcare facilities.

This form is used for providing written notification for the supervision of bathing facilities at temporary residences and campgrounds in New York.

This document is used for filing a complaint related to the Americans With Disabilities Act in New York. It is known as Form DOH-5238 Appendix C.

This Form is used for reviewing swimming pool plans in New York. It helps ensure that the plans are compliant with regulations and safety standards.

This Form is used for creating a safety plan for recreational aquatic spray grounds in New York.

This Form is used for applying for initial limited service laboratory registration in New York. It provides instructions on how to complete the application.

This Form is used for applying for a license to engage in a controlled substance activity in New York. The form provides instructions on how to fill out and submit the application.

This document provides instructions for filling out Form DOH-2177, DOH-2178, and DOH-2183 in New York.

This form is used for applying for health insurance in New York in Haitian Creole language.

This type of document is a complaint form specifically designed for individuals in New York who speak Chinese. It allows them to submit complaints to the Department of Health.

This form is used for filing a complaint with the Department of Health in New York. It is available in Russian language.

This document is a complaint form used in New York for individuals who speak Korean.

This type of document is a "Contract for Management Between Parent and Teenage Son/Daughter" in New York. It outlines the responsibilities and expectations between a parent and their adolescent child.

This Form is used for making changes and specifications to the New York State Donate Life Registry in New York.

This document is a mail-in application form for obtaining a copy of a divorce certificate in New York. Fill out and submit this form to request your divorce certificate by mail.

This form is used for filing a complaint regarding access to services in Haitian Creole within the state of New York.

This form is used for documenting the autopsy protocols for infants in the state of New York. It is a standardized document that provides details about the autopsy examination conducted on infants.

This Form is used for ordering materials related to tick-borne and mosquito-borne diseases in New York.

This form is used for obtaining information and attestation for the Nyscondom Program organization in New York.

This form is used for applying by mail to get a copy of a birth certificate in New York.

This form is used for applying by mail for a copy of a death certificate in New York.

This form is used for tracking and documenting controlled substances in New York. It helps ensure proper handling and accountability of these substances.