Self-attestation Form for Registrants 18 Years of Age and Older - New York City

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Self-attestation Form for Registrants 18 Years of Age and Older - New York City

Self-attestation Form for Registrants 18 Years of Age and Older is a legal document that was released by the New York City Department of Health and Mental Hygiene - a government authority operating within New York City.

FAQ

Q: What is the self-attestation form for registrants 18 years of age and older?
A: It is a form used in New York City for individuals to declare their eligibility for a vaccine.

Q: Who is required to fill out the self-attestation form?
A: Registrants 18 years of age and older who are eligible for a vaccine.

Q: Why is the self-attestation form necessary?
A: It is used to verify the eligibility of individuals for a vaccine.

Q: What information is required on the self-attestation form?
A: Personal information such as name, date of birth, and eligibility criteria.

Q: Is the self-attestation form for New York City residents only?
A: Yes, it is specifically for residents of New York City.

Q: Is the self-attestation form mandatory?
A: Yes, it is mandatory for individuals 18 years of age and older.

Q: What happens after submitting the self-attestation form?
A: Once the form is submitted, individuals will be contacted to schedule a vaccination appointment.

Q: Can I schedule a vaccine appointment without the self-attestation form?
A: No, the form is required to schedule a vaccine appointment in New York City.

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Form Details:

  • Released on April 1, 2022;
  • The latest edition currently provided by the New York City Department of Health and Mental Hygiene;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the New York City Department of Health and Mental Hygiene.

Download Self-attestation Form for Registrants 18 Years of Age and Older - New York City

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