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Preschool Provider Forms

Annual Billing Guidelines
Annual Review Cover Page
Annual Review Signature Page
Child Notification Form
Child Outcomes Summary Directions
Children With Special Needs Annual Attestation 2023-2024 Agency Billing Provider Cpse Portal Form
Children With Special Needs Annual Billing Guidelines - Cpse Evaluations
Children With Special Needs Annual Billing Guidelines- Cpse Center Based And Seis
Children With Special Needs Annual Builling Guidelines - Cpse Related Services
Coordination Of Services Andor Seit Requirements And Procedures
County Voucher
Cpse Evaluation Report
Cpse Related Services Parent Caregiver Signature Log
Cpse Voucher Verification - Evaluations Only
Extended School Year Cpse Documentation Form
Extended School Year Guidance For Preschool Children
Occupational Therapy Udo Certification And Log
Physical Therapy Udo Certification And Log
Physicians Prescription For Services
Provider Notification Form
Provider Profile Form
Psychological Counseling Uso Certification
Reconciliation Rate Adjustment Sheet - Seit Only For Seit Services Prior To July 2015
Reconciliation Rate Adjustment Sheet - Seit Only For Seit Services Starting July 2015
Reconciliation Rate Adjustment Sheet-Center Based Only
Seis Parent Caregiver Signature Log
Services Voucher Verification
Speech Language Services Udo Certification And Log
Speech Pathologists Recommendation For Speech Services
Substitute Provider Letter

Financial Disclosure Ethics Form - Pdf Version
Financial Disclosure Form Part A - Supplement
Financial Disclosure Form Part B - Supplement
Financial Disclosure Form Part C - Supplement
Financial Disclosure Form Part D - Supplement

Public Health Services Divisions

Community Health Services
Environmental Health Services
Family Health Services

Contact

Family Health

A Division of Schenectady County Public Health Services

Schaffer Heights
107 Nott Terrace Ste 306
Schenectady, NY 12308

Tel: (518) 386-2815
Fax: (518) 386-2801

Email Family Health

Family Health Services

Family Health - Events
Family Health - News

Early Intervention Program
Preschool Special Education
Nutrition- WIC Program
Breastfeeding/Chestfeeding Support
Healthy Schenectady Families

Schenectady County Seal

Schenectady County NY
620 State Street,
Schenectady, NY 12305

Schenectady County

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