Herkimer, Jefferson, Lewis, Oneida, Onondaga & Oswego Counties

Forms and other resources

 

Fifth District Program Forms | Health and Advanced Planning Forms | Family Law Forms | Links to other resources

 

Fifth District Program Forms

• Affirmation of Services for CLE
• Attorney Registration with Fifth District Program
• Certification of Pro Bono for other Programs
• Interpreter Non-Disclosure Agreement

 

Health and Advanced Planning Forms

• Appointment of Agent to Control Disposition of Remains
• Designation of Standby Guardian
• External Appeal Application for Health Care Consumers www.dfs.ny.gov/insurance/extapp/extappqa.htm
• HIPAA Release http://www.courts.state.ny.us/forms/Hipaa_fillable.pdf
• Health Care Proxy http://www.lawhelp.org/ny
• Health Care Proxy Revocation
• Living Will
• Power of Attorney

 

Family Law Forms

• Divorce (Contested) packet (request by email)
• Oral Stipulation Checklist

 

Links to useful sites:

• Legal Research, Law Libraries, Public Access Libraries and LION, the court system’s automated, on-line library
• NY Law Journal home page
• Library of Congress- Law Library - New York section www.loc.gov/law/guide/us-ny.html

 

If you would like to make a suggestion regarding our forms and links to forms – please send us an email staff@5thDistrictProBono.org