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- Click ‘Get Form’ to open the doe rsa form in the editor.
- Begin with Section 1: Student Information. Fill in the student's name, date of birth, and NYC ID number. Ensure all fields are completed accurately.
- Proceed to Section 2: Provider Information. Enter your name, address, telephone number, and Social Security number. This section is crucial for identifying the service provider.
- In Section 3: Agency Information, provide the agency's name, address, and Federal Tax ID number. This information validates your billing request.
- Move to Section 4: Service Provision. Document each session's date, frequency, start time, end time, and group size. Calculate the total number of sessions and total amount due at the end of this section.
- Finally, complete Section 5: Provider Certification by signing and dating the form. Ensure that a parent or guardian also signs to confirm service provision.
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