Get Ny Doh-61a 2003-2025

The NY DOH-61a form is a crucial document used to report injuries occurring in children's camps. This guide provides a clear, step-by-step explanation of how to complete the form online, ensuring all necessary information is captured accurately.

Follow the steps to successfully complete the NY DOH-61a form.

1. Click ‘Get Form’ button to access the NY DOH-61a form and open it in your editor.
2. Begin with section A, Facility Information, by entering the camp's name, facility code, address, and the date when the report is being filed.
3. Proceed to section B, Event Information. Fill in the eHIPS Incident Number, the date and time of the incident, and select the location of the injury, marking relevant options as needed.
4. In section C, Victim Information, provide the details of the victim, including their name, parent or guardian's name, home address, phone number, age, sex, and status. Indicate what the victim was doing at the time of the incident.
5. Continue to section D, Injury Information. Report the details of the injury by specifying the type, area injured, and cause. You can report up to four injuries for each victim.
6. Then fill out section E, Treatment, by indicating who provided treatment, the location of treatment, and the type of treatment administered.
7. In section F, denote the supervision during the incident and identify contributing factors that may have led to the injury.
8. Address section G, Investigation, by indicating whether an on-site investigation was conducted by local health authorities and including relevant dates.
9. Finally, complete section H, Narrative, by providing a detailed account of the incident without including full names of individuals involved. Ensure to describe the supervision, treatment, and any relevant post-incident information.
10. Once all sections are completed, review your form for accuracy, then save your changes, and either download, print, or share your report as needed.

Complete your documents online for efficiency and accuracy.