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OMH PC COVID-19 Screening State PC Admissions Form

OMH PC COVID-19 Screening State PC Admissions Form 2025

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4.9 out of 5

35 votes

The document is a COVID-19 screening form for admission to New York State Office of Mental Health inpatient services. It requires information about the patient's recent travel history, potential exposure to COVID-19, symptoms experienced, and details from the referring physician or nurse practitioner.

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Versions	Form popularity	Fillable & printable
2022	4.3 Satisfied (44 Votes)
2020	4.9 Satisfied (35 Votes)

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