Frequently Requested Information and Forms

Assisted Living

Forms and other information related to assisted living facilities and related issues in New York State

Communicable Disease Reporting Form

The NYS Dept. of Health form for reporting communicable diseases

Dental Health Educational Materials and Publications

Order Form (PDF 16KB 1pg)

Child Health Plus

Information about Child Health Plus insurance program

Diabetes

Order form for a range of information about managing diabetes

Elderly Pharmaceutical Insurance Coverage

(EPIC)

Family Health Plus Application

This application can be used to apply for Child Health Plus, Family Health Plus, Medicaid and the Family Planning Benefit Program

Family Planning Benefit Program Materials

Order Form (PDF, 16KB, 1pg.)

Health Care Proxy Form

Appoint someone you trust to make health care decisions for you if you lose the ability to make decisions yourself.

Healthy New York Program

Information on this health insurance program designed to assist small business owners, their employees and their employees’ families as well as uninsured sole proprietors and workers whose employers do not provide health insurance

HIV Uninsured Care Programs

A program for free health care (HIV Drugs, Primary Care, Home Care, and APIC) for New York State residents with HIV infection who are uninsured or underinsured

Medicaid Application

This one application can be used to apply for Child Health Plus, Family Health Plus, Medicaid and the Family Planning Benefit Program

Patient Bill of Rights

Your rights as a hospital patient in New York State

  • MyHealthy Decisions | Total Ankle Replacement

    Jim Lambert loves to take long walks with his wife, but when pain from an old ankle injury made walking difficult, he started to look at surgical options. Jim's wife showed him an article in MyHealthy Decisions Magazine about the total ankle replacement surgeries that Bassett was doing, and he reread more

    MyHealthy Decisions | Robotic-Assisted Partial Knee Replacement

    James Flannery, of Oneonta, NY, was experiencing knee pain that was holding him back from work and doing the things he loves. After consultation with Dr. Michael Diaz, James opted for robotic-assisted partial knee replacement surgery using A.O. Fox Hospital's state-of-the-art NAVIO system. Watch read more

One Atwell Road Cooperstown, NY 13326

607-547-3456 : 1-800-BASSETT (227-7388)