Forms and 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 Person in Parental Relationship
Designation of Standby Guardian
External Appeal Application for Health Care Consumers (used to appeal denial of health care coverage by an insurance company) http://209.63.37.85/mssnycfm/mssnyeditor/File/Physician_ Resources/Guidelines/ExternalAppeal/ConsumerAppl06.pdf
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)	email
Oral Stipulation Checklist

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

Links to useful sites:

Legal Research, Law Libraries, Public Access Libraries and LION, the court system’s automated, on-line library www.courts.state.ny.us/lawlibraries/index.shtml

NY Law Journal home page
www.law.com/jsp/nylj/index.jsp

Library of Congress- Law Library - New York section www.loc.gov/law/guide/us-ny.html