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Translated Insurance Documents

New York State Department of Health
Bureau of Early Intervention Electronic Mailing List

Translated Insurance Documents


Dear Colleague:

The Department of Health is pleased to announce the availability of translated versions of required documents used to collect insurance information from families in the Early Intervention Program (EIP) related to insurance use, rights and protections. 

The Child Insurance Information Form, Child Insurance Information Form Instructions and Parent Notice Regarding Insurance have been translated into the six most common non-English languages spoken in the state, as identified through the Governor’s Office. 

These languages are: Spanish, Common Chinese, Haitian-Creole, Italian, Korean and Russian.  

Service Coordinators are required to use the Child Insurance Form to collect insurance information from families of children who have been referred to the EIP, and to provide a copy of the Parent Notice Regarding Insurance to parents to explain the use of public and private insurance in the EIP and the rights and protections afforded to parents.

Child Insurance Information Form B, Child Insurance Information Form Instructions and Parent Notice Regarding Insurance (non-English versions): Spanish, Chinese, Italian, Russian, Korean, Haitian Creole can be accessed at:
https://www.health.ny.gov/community/infants_children/early_intervention/memoranda.htm

Please contact beipub@health.ny.gov should you have any questions regarding these documents.

Article ID: 360, Created On: 7/7/2017, Modified: 7/7/2017

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