Published on New York State Department of Health, Wadsworth Center (https://wadsworth.org)

Hospital Contacts and Designee

The Hospital Contacts and Designee Form must be completed annually and whenever there are any changes in hospital staff/responsibilities.

This designee form should be submitted through the Health Electronic Response Data System (HERDS) application in the Health Commerce System. To complete the form, you must sign into the Health Commerce System. This form is not part of the newborn screening application.