Get Doh 5090

The Doh 5090 form is essential for verifying the identity of children aged 17 or younger through the New York State Health system. This guide will provide clear, step-by-step instructions to help you accurately complete and submit the form online.

Follow the steps to fill out the Doh 5090 effectively.

1. Press the ‘Get Form’ button to access the Doh 5090 online, where you can begin filling out the necessary information.
2. Enter the applicant name, which should be the child's full name as it appears on their official documents.
3. Fill in the address of the applicant, ensuring the street address is correct.
4. Include the city in which the applicant resides.
5. Specify the state of residence for the applicant.
6. Provide the ZIP code associated with the applicant's address.
7. List the date of birth of the applicant in the format mm/dd/yyyy.
8. Enter the Social Security number of the applicant.
9. Provide a telephone number where a parent or guardian can be reached.
10. Select and upload copies of the required documents. Submit one document from List A, or two documents from List B, or one document from List C to verify the applicant's identity.
11. Complete the attestation section, confirming that the information provided is accurate and true to the best of your knowledge.
12. Have the parent or guardian sign the form, indicating their relationship to the applicant.
13. Enter the date on which the form is being completed in the format mm/dd/yyyy.
14. Finally, review all information, save your changes, and submit the form. Ensure that all uploaded documents are clear and legible.

Start filling out the Doh 5090 online today to complete your identity verification process.