Please submit the following documents at your earliest convenience within two weeks of your interview. If you have any questions, please do not hesitate to reach out.

• New York State License/Certification and/or Registration
• Bilingual Extension (if applicable) - Copy of BEA score or printout from TEACH account
• Annual Medical with PPD and immunizations
• Recommended Vaccination Acknowledgment
• Medicaid #
  (if applicable- for SLP’s & Clinical Psychologists)
• Continuing Education Workshop certificates
• Three Professional Reference Letters
  (MUST include date, phone number & signature)
• Form W-4
• IT-2104 State Tax form
• Therapist Referral Form
• Policies and Procedures
  • Annual Training Requirements
  • HIPPA Training
  • Session Note Submission Form
  • Marketing and Social Media Release Form
  • Stop Sexual Harassment Act Factsheet
  • NYC Lactation Policy
• Online forms
  (please note an account will need to be created to access trainings)
  • Compliance Plan Training
  • CPSE Waiver (CPSE only)
  • Health, Safety & Confidentiality Policies
  • NPI Number
  • NYC Early Intervention New Provider Orientation
  • NY Preschool Code of Conduct (CPSE only)
  • Sexual Harassment Training
    (submit certificate of completion for credit)
  • Early Intervention Evaluation, Assessment, and Eligibility Determination
    (EI Evaluators only, submit certificate of completion for credit)