Forms & documents

Whether you are renewing a license, submitting proof of training to DOH, or applying for the new market rate, here you can find the forms and information you'll need.
Certification and Licensing
-
Training Record Form – Informal Providers
Informal providers should use this form to record any training sessions they attend. Informal providers who complete 10 or more hours of approved training in at least two different approved topics may be eligible to receive a higher, "enhanced" market rate once their training has been verified by the Enrollment Agency.
-
Provider/Program Enrollment or Update Request Form
Administration for Children's Services
Division of Child Care/Head Start Child Care Support Services; Provider / Program Enrollment or Update Request
Contracts
-
UFT Providers Memorandum of Agreement MOA 06-10 2022
MEMORANDUM OF AGREEMENT between the ֱ (the “Union” or the “UFT”) and the State of New York (the “State”) through the New York State Office of Children and Family Services (“OCFS”), the New York State Division of the Budget (“DOB”) and the New York State Department of Health (“DOH”).
Dental
-
Provider Wellness Dental Coverage Tier II
Tier 2 dental coverage for Providers from EmblemHealth
-
Provider Wellness Dental Plan Tier II (Español)
Tier 2 dental coverage for Providers from EmblemHealth
Health Benefits
-
Provider Wellness WellSpark presentation
Presentation to providers about lifestyle coaching and wellbeing resources courtesy of WellSpark Health
-
Provider Wellness health care premium reimbursement brochure
Get reimbursed for up to 100% of the out-of-pocket premium costs of your qualified NY State of Health Marketplace health plan.
-
UFT Providers Telemedicine
Virtual Care Plan for UFT Family Childcare Provider Members
-
UFT Providers Telemedicine (Español)
Plan de Cuidado Virtual para Miembros de Proveedores de Cuidado Infantil Familiar de UFT
Informational
-
What happens when I report a suspected case of child abuse or neglect?
A flowchart from the New York City Administration for Children's Services.
Insurance
-
Family Child Care Providers - life insurance enrollment card
This card may be printed and submitted by members of the UFT Family Child Care Providers chapter to enroll in a free life insurance benefit of $10,000.
Membership
-
UFT Providers executive board duties
Duties of the Officers of the UFT Providers Chapter
Mental Health
-
Provider Wellness Helpline
Provider Wellness participants now have FREE access to the UFT helpline provided by Vibrant Emotional Health.
-
Provider Wellness Helpline (Español)
Los participantes de Provider Wellness ahora tienen acceso GRATUITO a la línea de ayuda de UFT proporcionada por Vibrant Salud Emocional.
Payments
-
Child Care Provider Attestation of Costs Form OCFS-6060
This form is used to request a Market Rate increase if you serve only children receiving child care assistance.
-
Rate Increase Request Form for Providers NYC FS-023
This form is used to request a Market Rate increase if you serve both children receiving child care assistance and children who do not receive child care assistance (private pay).
-
Formulario De Atestacion De Costos Del Proveedor De Cuidado Infantil OCFS-6060-S
Utilice este formulario para solicitar un aumento de tarifa si:
- Usted no tiene un contrato con un distrito local Y
- Usted solo cuida niños recibiendo asistencia de cuidado infantil.
Salary and Payroll
-
Market Rate Application Form – Informal Providers
Moving forward, all informal providers will receive the standard 2007 market rate without having to apply. In order to receive the 2007 rate retroactively, informal providers must apply for it and attest that their cost of care has increased. Please use this form to apply for the market rate retroactively.
-
Market Rate Application Form – Registered Family and Licensed Group Providers
Registered family and licensed group providers whose rates listed on file with ACS are not already higher than the 2007 market rate should use this form to apply to receive the new market rate moving forward and retroactively.
Taxes
-
Record Keeping and Taxes: A Guidebook For Family and Group Family Child Care Providers
The information and forms in this booklet can help you keep track of your child care business income and expenses in a way that will make sense to you and your tax preparer when the time comes to file your tax returns. (English)
-
Contabilidad e Impuestos: Una guía para proveedoras del cuidado infantil diurno con licensias de la familia y de familia-grupo
La información y formas en este manual le puede ayudar a manejar la renta y gastos de su negocio del cuidado infantil diurno de una manera que tenga sentido para usted y la persona que prepare sus impuestos cuando llega el momento para entregar las declaraciones de impuestos. (Spanish)
Teaching
-
Right from the start
Transition strategies for developing a strong preK-3 continuum. An AFT publication.
Vision
-
Provider Wellness Vision Plan (English)
With Your EmblemHealth Vision Benefits, You...
- Have access to one of the nation’s largest networks of independent eye doctors and national retail and regional retail providers.
- Can use glasses.com and contactsdirect.com as in-network providers to easily find and purchase glasses and contacts – all shipped directly to your front door.
-
Provider Wellness Vision Plan (Español)
Con los beneficios de la vista de EmblemHealth, usted...
- Tendrá acceso a una de las redes de oculistas independientes más grandes del país y a proveedores minoristas nacionales y regionales.
- Puede usar glasses.com y contactsdirect.com (solo en inglés) como proveedores de la red para encontrar y comprar anteojos y lentes de contacto fácilmente, enviados directo a la puerta de su casa.