Skip to Main Content
Nassau County, NY
Homepage
  1. Government
  2. Departments
  3. Residents
  4. Visit Nassau
  5. Business & Investor Relations
  6. e-Services
  7. Nassau A-Z
  1. Home
  2. Departments
  3. Health Department
  4. For Providers

For Providers


1. EI Referral Form EI 5049.B 10.21.2015

2. Bilingual Justification Form EI 5216

3. FAMILY ASSESSMENT 10.2018

4. Home Lang Survey EI 5231 03-2015

5. Confirmation of EI Services EI 5400 rev. 7.16.15

6. IFSP Consent Form EI 5170.6 11.14

7. NC DOH Make up Policy EI 6401 rev. 10.27.2017

8. Early Intervention Program Provider Progress Report 9-16 use

9. ABA Fax Cover EI 5359 10.04.2018

10. ABA Calendar Template

11. ABA Family Training Progress Report 2018

12. ABA Team Leader Progress Report 2018

13. ABA Team Member Progress Report  2018

14. NYS EIP Assistive Technology Medical Necessity Justification Form w Instructions 11 2014 

15. NYS ATD Notification of Item Delivery Condition and Status 11 2014

16. IFSP Amendment Request EI 5093 A 6.6.16

17. IFSP Amendment Request Questions  EI 5093 B 5.13.2016

18. Notification of Nondelivery of Authorized Services  EI 5201 rev 09-2017

19. OSC Provider List 9 17

20. OSC Provider List Contact Info 9 17

21. OSC Provider List Key 9 17

22.CPSE Notice of Eligibility Determination EI 5235 02.10

  1. Health Department Home
  2. About Us
  3. A - Z of Resources
  4. Child and Family
    1. Early Intervention
    2. WIC
    3. Preschool Special Education
    4. Cribs for Kids
    5. Childhood lead poisoning prevention
    6. Healthy Moms and Babies
    7. Child Fatality Review Team
    8. Perinatal Services Network
    9. Perinatal Data
  5. Data & Reports
  6. Employment & Volunteer Opportunities
  7. Environment Health
    1. Environmental Health Brochure (PDF)
    2. Food Protection
    3. Lifeguards
    4. Public Water Supply
      1. Water Quality Foreword
      2. Major Findings
      3. Sampling Site Selection Criteria
      4. Monitoring Results From Public Supply Wells
      5. Nitrate Nitrite and Perchlorate
      6. Recommendations
      7. Appendix A
      8. Perchlorate and Nitrate
      9. Appendix B
      10. Appendix C
      11. Appendix D
      12. Appendix E
      13. Appendix F
      14. Appendix G
      15. Appendix H
      16. Monitoring Results Golf Course Irrigation Wells
  8. Petroleum Bulk Storage
  9. Toxic & Hazardous Material Storage
  10. Small Petroleum Tank Abandonments and Removals
  11. FAQ
  12. Fight the Flu 2020
  13. Food Managers Training Course
  14. Medical Reserve Corps (MRC)
  15. Mosquito Surveillance and Control
  16. Need a Form?
  17. News Releases
  18. Programs and Services
  19. Public Health Emergency Preparedness (PHEP)
  20. Regulations & Enforcement
  21. Contact Us
  22. FOIL Requests
  23. Parent Information
  24. For Providers
  25. Attention Therapists and Agencies
  26. Child Safe Summer
  27. Record Requests
  28. Coronavirus COVID-19
  29. Breast Cancer and Prostate Health
  30. Health Disparities Study RFP
  31. Food Services COVID-19 Resources
  1. Home
  1. Accessibility
  1. Browser Support
  1. Copyright Notices
  1. Disclaimer
  1. Employment Opportunities
  1. Privacy Policy
  1. Site Map
  1. Contact Us
  1. Powered by CivicPlus®
/QuickLinks.aspx
Arrow Left Arrow Right
[]
Slideshow Left Arrow Slideshow Right Arrow