This is a legal form that was released by the New York State Department of Health - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is DOH-4334?
A: DOH-4334 is a form for reporting Methadone Usage Summary in New York.
Q: Who needs to fill out DOH-4334?
A: Healthcare providers who administer or dispense methadone in New York need to fill out DOH-4334.
Q: What information is required in DOH-4334?
A: DOH-4334 requires information about the total amount of methadone dispensed, the number of patients, and any dosing errors or incidents.
Q: Why is DOH-4334 important?
A: DOH-4334 helps the New York Department of Health monitor and regulate the usage of methadone to ensure safe and effective treatment.
Q: How often should DOH-4334 be submitted?
A: DOH-4334 should be submitted on a monthly basis, by the 15th of the following month.
Q: What are the consequences of not submitting DOH-4334?
A: Failure to submit DOH-4334 or submitting false information may result in penalties or disciplinary actions.
Q: Is DOH-4334 for methadone clinics only?
A: No, DOH-4334 is for any healthcare providers who administer or dispense methadone, including clinics, hospitals, and pharmacies.
Q: Can I submit DOH-4334 electronically?
A: Yes, you can submit DOH-4334 electronically through the Health Commerce System (HCS) or the Electronic Clinical Laboratory Reporting System (ECLRS).
Form Details:
Download a printable version of Form DOH-4334 by clicking the link below or browse more documents and templates provided by the New York State Department of Health.