Please use this form if your member requires a CIN Change.
This form can be used to request a client name change request.
Form for voiding any assessment other than HMLs.
*This form should NOT be used to request HML voids!
Submit a request to restore missing data (e.g. notes, HMLs, other assessments) into a chart.
Request to create a new Netsmart report or to notify HHUNY of an issue with an existing Netsmart report.
Request to void a note in a member's chart.
Request a member's status be changed from one status to another