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Forms & documents

update your beneficiary forms

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

Health Benefits

Informational

Insurance

Membership

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

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

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.