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  • Ny Doh-4452 2016

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Must complete at least 7 of these topics at their highest level of certification. CIC Internship Tracking Form Date Completed Hours Completed Supervising CIC (Signature and CIC Number) Workforce Safety and Wellness Documentation Medical/Legal and Ethics Principles of Pharmacology Emergency Medications Airway Management Respiration Scene Size-Up Primary Assessment History Taking Monitoring Devices Neurology Infectious Diseases Endocrine Disorders Psychiatric Cardiovascular Toxicology Respirat.

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How to fill out the NY DOH-4452 online

The NY DOH-4452 form is essential for tracking the completion of specific topics related to emergency medical services and training. This guide provides step-by-step instructions to assist users in successfully filling out this form online.

Follow the steps to complete the NY DOH-4452 form

  1. Press the ‘Get Form’ button to acquire the form and open it in your preferred editor.
  2. Begin by entering the candidate’s name in the appropriate field labeled 'CIC Candidate’s Name (print)'. Ensure that the name is printed clearly.
  3. Fill in the EMT number in the designated area next to where you entered the candidate’s name.
  4. In the next section, input the name of the supervising CIC in the field labeled 'Supervising CIC’s Name (print)'. Again, ensure clarity in your entry.
  5. Enter the supervising CIC's number in the corresponding field next to the name.
  6. The supervising CIC must sign the form in the section labeled 'Supervising CIC’s Signature'. This is an important field that validates the completed form.
  7. Record the date of signing in the designated area labeled 'Date'. It's important to use the correct date format.
  8. Review the sections for courses completed, hours counted, and topics covered to ensure all information is accurately filled out.
  9. Once you have reviewed all fields for accuracy, you may then decide to save your changes, download a copy for your records, print the completed form, or share it with relevant parties.

Complete your NY DOH-4452 form online today for efficient processing.

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