Get Ny Doh-5153 2024-2026

The NY DOH-5153 form is an essential document used by the New York State Department of Health to assess a child's activities in connection to an application for disability benefits. This guide will walk you through the process of filling out this form online, ensuring clear understanding and ease of completion.

Follow the steps to successfully complete the NY DOH-5153 online

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Enter the child's name in the designated field, ensuring you include the last name, first name, and middle name.
3. Fill in the case number, date of birth, agency, client ID number, and disability ID number as required.
4. Indicate the child's sex by selecting either male or female.
5. Provide the worker's name in the respective field, along with a contact phone number.
6. Date the form with the current date you are filling it out.
7. Carefully answer the questions regarding the child’s abilities, including mobility issues, behavior around peers, speech, self-care, play, and any observed behavioral problems.
8. If applicable, complete the section concerning the child’s school by providing the name of the school, the teacher's name, and whether the child is in a special education program. Elaborate on any needs for additional help.
9. Discuss any issues related to the child's school attendance or performance in the provided section.
10. Complete the personal information section by entering your name, relationship to the child, and your contact telephone number.
11. Finally, review all provided information for accuracy. Save any changes made. You may choose to download, print, or share the completed form as needed.

Complete your NY DOH-5153 form online today for a smooth application process.