PAS Forms - OASAS - NY 2026

1. Click ‘Get Form’ to open the PAS Forms - OASAS - NY in our editor.
2. Begin by entering the applicant's information. Fill in the name, date of birth, last four digits of the Social Security number, and the date of the last fingerprinting.
3. Next, provide details about who the applicant was fingerprinted for by filling in the relevant section.
4. Move on to your provider information. Enter the provider name, provider number, and indicate if you are a dually licensed provider by selecting 'Yes' or 'No'.
5. Specify the job title that the applicant is applying for in the designated field.
6. If applicable, complete any additional information required in this section.
7. In the provider certification area, ensure that all fields are filled out accurately including your name, title, email address, phone number, signature, and date.

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