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NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Application to Local Registrar For Copy of Birth Record CERTIFICATE INFORMATION First Middle Last Date of Birth Name Hospital (if not hospital,
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doh-296a is a form used for reporting specific health information to the Department of Health.
Healthcare providers and facilities are required to file doh-296a.
doh-296a can be filled out electronically or manually following the instructions provided by the Department of Health.
The purpose of doh-296a is to collect and monitor health data for regulatory and public health purposes.
Information such as patient demographics, diagnosis, treatment provided, and outcome must be reported on doh-296a.
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