School Medical Director Assistance Request Form

1.

NYSCSH provides consultation to the New York State Center for School Health regarding issues related to the role of School Medical Director practice in NYS schools.

If you would like assistance regarding a School Medical Director question or concern, please complete this form and a response will provided within 2 business days.

Question Title

* First Name

Question Title

* Last Name

Question Title

* Credentials

Question Title

* Email Address

Question Title

* Phone Number

Question Title

* Are you a NYSCSH Health Information Portal (HIP) email subscriber?

Yes