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This document provides instructions and data element definitions for the reporting of cardiac surgeries performed on adult patients (age 18 and over) within New York State. It serves to ensure accurate

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How to fill out doh-2254a - health ny

How to fill out DOH-2254a

01

Obtain the DOH-2254a form from the official New York State Department of Health website.

02

Carefully read the instructions provided with the form to ensure proper completion.

03

Fill in the name of the facility or organization for which the form is being completed.

04

Enter the contact information, including the address, phone number, and email of the facility.

05

Complete the relevant sections pertaining to the services provided by the organization.

06

Include any required demographic information regarding the population served.

07

Review the filled-out form for accuracy and completeness.

08

Submit the form as per the instructions provided, either online or by mail.

Who needs DOH-2254a?

01

Healthcare facilities and organizations that provide services under the New York State Department of Health programs need to complete DOH-2254a.

02

Organizations seeking approval or funding from the Department of Health must also file this form.

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What is DOH-2254a?

DOH-2254a is a form used for reporting immunization information for children and adolescents in New York State.

Who is required to file DOH-2254a?

Health care providers, including physicians and clinics, are required to file DOH-2254a when they administer immunizations to patients.

How to fill out DOH-2254a?

To fill out DOH-2254a, provide patient demographic information, immunization details, and the provider's information, ensuring accuracy in reporting.

What is the purpose of DOH-2254a?

The purpose of DOH-2254a is to maintain a comprehensive immunization record for public health monitoring and to facilitate immunization compliance.

What information must be reported on DOH-2254a?

Information required includes the patient's name, date of birth, address, immunization dates, vaccine type, and the provider's details.

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