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How to Use or Fill Out the NYS Health Care Provider Release Form Online
- Click ‘Get Form’ to open it in the editor.
- Begin by entering the 'Date of Exam' in the designated field. Ensure accuracy as this is crucial for record-keeping.
- In the 'Name' section, print your name clearly. Follow this by filling out your 'School' information.
- Provide a detailed 'Diagnosis' of the skin lesion(s) and specify their 'Location AND Number of Lesion(s)'.
- List any 'Medication(s) used to treat lesion(s)' and indicate when treatment started by filling in the 'Date Treatment Started' and time.
- Select one of the two options regarding contagion status by checking the appropriate box before signing.
- Finally, ensure that you sign and date the form, and include your printed name and office details for verification.
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