Get Ny Doh Physician Survey

This guide provides step-by-step instructions for completing the New York State Department of Health (NY DoH) Physician Survey online. It is essential for physicians to accurately report their information, as it contributes to public health data and ensures compliance with regulations.

Follow the steps to complete the survey efficiently.

1. Press the ‘Get Form’ button to access the online survey. This will allow you to download the form and get started with the required information.
2. Provide your name and preferred mailing address. Ensure that the address is accurate for contact purposes, as it will not be made public.
3. Indicate if you request any changes or additions to the preprinted information. Mark the corresponding blue box to confirm your modifications.
4. Fill out your contact information, including phone number and email. This information is also kept confidential.
5. Complete sections regarding your primary and secondary fields of practice. Use the provided codes from the Fields of Practice Codes insert to specify your areas of expertise.
6. Report on your educational background, including the name of your medical school and the year of graduation. Include details about your graduate medical education if applicable.
7. Provide information about any hospital privileges, including the names and codes of hospitals where you have admitting privileges.
8. If applicable, detail any malpractice payments made on your behalf within the last ten years. Include the type of award, date, amount, and the name of your insurance carrier, if relevant.
9. Disclose any actions taken against your license by the New York State Board of Professional Medical Conduct or similar licensing entities within the past ten years.
10. Review all provided information carefully for accuracy and completeness before final submission.
11. At the end of the survey, you will have the option to save changes, download a copy, print the form, or share it as needed.

Encourage fellow physicians to complete the NY DoH Physician Survey online to ensure their profiles reflect accurate and up-to-date information.