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OASAS Provider Forms

Unless otherwise noted, the forms available through this page are in PDF format and can be viewed and printed using Adobe Acrobat® Reader™. Some of the available forms can be filled in on your computer using Adobe Acrobat Reader version 4.0 or later and will be noted as such. Acrobat Reader does not allow you to save your completed, or partially completed, forms to a disk or on your computer.

For information regarding how to obtain a hard copy of the forms provided below, please contact your local Field Office.

Regulatory Forms Category UPDATED

The Regulatory Forms category has been updated and now contains forms and resources related to the following regulations: Part 817, Part 818, Part 819, Part 822, Part 823, Part 828 and Part 857.

Certification Application and Review Documents Editable PDF Icon

Used by service providers, excluding those providers subject to Article 28 of the Public Health Law, to request prior OASAS approval for specific actions related to (1) the certification of new chemical dependence treatment services or (2) changes in the circumstances under which currently certified chemical dependence treatment services are provided.

IRM-15 Form Editable PDF Icon

The OASAS External User Access Request is used to request access to OASAS' automated sysems.

PAS Forms

These forms are used to report program activities and services, client demographics and fiscal and programmatic accountability.

PAS-xxG Forms and PAS-xxN Forms are available on the Client Data System.

PDS Forms

Forms from the Education and Training Provider Certification Application Packet

PPD Forms

These forms are used to assess preliminary certification proposals.

PR Forms

Prevention forms

SQA-6 Form PDF Icon

Request for Site Evaluation and Preliminary Environmental Assessment

TRS Forms

Includes a variety of forms for program operations, including client consent forms that comply with 42 CFR and HIPAA requirements