NEW YORK STATE DEPARTMENT OF HEALTH Bureau of Narcotic Enforcement Check if Renewal Application for Certification as Euthanasia Technician for Animals Reg. No. APPLICANT Name Last First Middle Initial Home Address City State Zip Home Telephone No. Date Of Birth - - MINIMUM QUALIFICATIONS Type of Degree/Major Date Received - - College or University Address Qualifying Experience attach separate sheet PRESENT EMPLOYER S Attach separate sheet if nec.

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How to fill out the NY DOH-4332 online

The NY DOH-4332 form is essential for individuals seeking certification as euthanasia technicians for animals. This guide provides step-by-step instructions to help users fill out the form accurately and efficiently, ensuring all necessary information is provided.

Follow the steps to complete the application seamlessly.

  1. Press ‘Get Form’ button to access the NY DOH-4332 application for certification as an euthanasia technician online.
  2. In the applicant section, enter your personal details, including your last name, first name, and middle initial in the designated fields.
  3. Provide your home address, including city, state, and zip code. Ensure that you enter the data accurately to avoid any potential delays.
  4. Fill in your home telephone number and date of birth using the format provided (MM-DD-YYYY).
  5. Under minimum qualifications, state the type of degree and major you obtained, as well as the date you received it.
  6. List the college or university you attended, followed by the institution's address, including city, state, and zip.
  7. Detail your qualifying experience. If additional space is needed, attach a separate sheet with this information.
  8. Next, provide information about your present employer(s). Fill in the name and address, including city, state, and zip for each employer.
  9. Include your present employer's telephone number and specify the length of employment in years and months.
  10. Indicate whether your present employer is an incorporated society, municipal animal control facility, or other—specifying as necessary.
  11. Lastly, in the affirmation section, sign and date the application to confirm that all provided information is true and accurate.
  12. Once completed, save your changes, and you will have the option to download, print, or share the form as needed.

Ensure your application is completed accurately by following these steps and submit your documents online.

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NY DOH-4332 Form

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