Chronological Updates: July 29, 2022 COVID Attestation Form Effective immediately, Nassau County Early Intervention will no longer require EI providers and families to sign the COVID Attestation Form prior to rendering in person evaluations and services. The Department may reinstate this attestation in the future if deemed necessary by county health officials. Please be reminded that even though this form is no longer required, providers should self-monitor for Covid symptoms each day and not enter any home, daycare or provider setting if any symptoms or conditions are present. December 9, 2020
This document is to be completed by the provider and the family prior to the start of in-person services. This form is to be completed one time when in-person services resume. This document must be attached to the child’s integrated case in NYEIS.
This form is to be completed by the provider at every in-person session. This form requires the signatures of the provider and family member attesting to the accuracy of the information for all household members.