Follow the steps to successfully complete the NY OCFS-6004 online.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by providing the program's name and facility ID number at the top of the form. This information is crucial for identification and processing.
3. Fill in the person's name and date of birth. Make sure to enter this information clearly to avoid any issues during review.
4. Select the type of program from the options provided, such as family day care, group family day care, or school-age child care.
5. Indicate the role of the individual completing the form, whether they are a provider, employee, volunteer, or household member. Ensure that you accurately reflect the person's role in the program.
6. The medical status section must be completed and signed by a qualified healthcare provider. This section requires the health care provider to assess the individual for any communicable diseases or physical conditions that could impact their ability to work with children.
7. If any of the medical status questions receive a 'YES' response, the healthcare provider should clarify and indicate any necessary restrictions. This ensures the health and safety of the children in care.
8. The healthcare provider should print their name, title, and contact information, as well as the date of the exam and the date of signature. This verification is essential for the form’s legitimacy.
9. If applicable, complete the tuberculin test information on the reverse side of the form, as required by certain roles. The healthcare provider must complete this section and sign it.
10. Once all sections are filled out, review the entire form for clarity and completeness. Users can then save changes, download, print, or share the form as needed.

Ensure the health and safety of children by completing the NY OCFS-6004 online today.