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NEW YORK STATE DEPARTMENT OF HEALTH Child and Adult Care Food ProgramOnSite Provider Addendum CA CFP Agreement #___SEE REVERSE FOR OWNER/OPERATOR AND ONSITE PROVIDER RESPONSIBILITIES. Provider #___Owns/operates
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How to fill out on-site provider addendum on-site
How to fill out on-site provider addendum on-site
01
Ensure you have the necessary information and documentation for the provider you are adding on-site.
02
Fill out the on-site provider addendum form accurately and completely.
03
Review the form for any errors or missing information before submitting.
04
Submit the completed on-site provider addendum form to the appropriate department for processing.
Who needs on-site provider addendum on-site?
01
Any organization or company that is adding a new provider to work on-site at their location.
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What is on-site provider addendum on-site?
The on-site provider addendum is a form used to provide additional information about a service provider who is physically present at the location.
Who is required to file on-site provider addendum on-site?
Any service provider who is physically present on-site is required to file the on-site provider addendum.
How to fill out on-site provider addendum on-site?
The on-site provider addendum can be filled out electronically or by hand, providing all requested information accurately.
What is the purpose of on-site provider addendum on-site?
The purpose of the on-site provider addendum is to ensure that all necessary information about on-site service providers is properly documented.
What information must be reported on on-site provider addendum on-site?
The on-site provider addendum may require information such as name of service provider, contact information, services provided, and any relevant certifications or licenses.
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