Referral Form: Use ONE
After Health Department approval and crib is delivered, use all the following forms at home visit:
3 Month follow-up Questionnaire:
Supplemental/supporting information for home visits:
How to Set up your Cribette
How to Set Up Your Pack N Play
Commissioner of Health
200 County Seat Drive
North Entrance
Mineola, NY, 11501
Directions
Phone: 516-227-9697
After Hours and Weekends Emergencies
(516) 742-6154
Hours
Monday-Friday
9 a.m. – 4:45 p.m.
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