Seneca County Forms
- Weatherization Program Application
- Traffic Ticket Plea Reduction by Mail
- Freedom of Information Request Form
- Building Permit Application
- Code Enforcement Applications
New York State Forms
Asbestos
Assisted Living
Birth, Death, Marriage, Divorce
- Birth Certificates
- Death Certificates
- Marriage Certificates
- Divorce Certificates
- Genealogy Copies
- Adoption Information Registry Forms
Certificate of Need
Child & Adult Care Food Program
- Applications and Forms for Participating Day Care Centers
- Applications and Forms for Participating Day Care Homes
Controlled Substances / Narcotic Enforcement
Dental
Diabetes
Early Intervention
- Application for Approval of Individual Evaluators, Service Providers, and Service Coordinators
- Application for Approval of Agencies or Incorporated Groups of Individuals as Evaluators, Service Providers, and Service Coordinators
- Early Intervention Publications Order Form
Emergency Medical Services (EMS)
- Forms Commonly Used by EMS Providers and Agencies
- Training Authorization Letter Form
- Forms Used in EMS Education
- Recertification Forms
- Reciprocity Forms
Health Care Coverage
- Child Health Plus
- Elderly Pharmaceutical Insurance Coverage (EPIC)
- Family Health Plus
- Family Planning Benefit Program
- Health Insurance and Nutrition Application for Children, Adults, and Families
- Healthy New York Program
- HIV Uninsured Care Programs
- Medicaid
- Medicaid Obstetrical and Maternal Services (MOMS) Program
- Prenatal Care Assistance Program (PCAP)
- Women, Infants, and Children (WIC) Nutritional Program
Health Care Proxy
Health Care Reform Act (HCRA)
HIV/AIDS
Home Care Services Agencies
Hospital & Primary Care Services
Infection Control
Managed Care
- Provider Contract Statement and Certification (DOH 4225)
- Utilization Review Agent Registration Application and Attestation (DOH 4291A)
- Utilization Review Agent Registration Application Summary/Checklist (DOH 4291B)
- Disclosure Information for Character and Competency Review (DOH 793B)
- Disclosure of Affiliations with Other Health Care Operations(DOH 793C)
- Regulatory Compliance Statement (DOH 794)
Medicaid
Medicaid Provider (NYS)
Mortality
Narcotic Enforcement
Nursing Home Administrator (NYS)
- Criminal History Record Check Request Form
- Nursing Home Administrator Licensure Application and Continuing Education Reporting Forms
Nursing Home Nurse Aide (NYS)
Official Prescription Program
Organ and Tissue Donor Registry (NYS)
Pesticides
Professional Licenses
Professional Medical Conduct
Public Water Supply and Protection
- Cross-Connection Control
- Drinking Water State Revolving Fund (DWSRF)
- Operator Certification
- Water System Operation