Demonstration of Need for the Entity’s Services

The Education Law and Commissioner’s Regulations allow the Department to issue a waiver from the corporate practice restrictions to a qualified entity that was created on, before or after June 18, 2010 that submits a waiver application after July 1, 2012. An entity making such an application must demonstrate, to the satisfaction of the Department, that there is a need for the professional services provided by the entity. Section 59.14(c) of the Commissioner’s Regulations defines a need for services to include, but not be limited to the fact the entity provides services to an underserved population or in a shortage area.

In order for the Department to make a determination about the need for the entity’s services, please complete this form and submit it with your application for the waiver.

Entity’s name:

Date the entity was established:

Provide the demographics (e.g., age, ethnicity, etc.) of those served by the entity:

Provide a socio-economic description of the geographic area served by the entity:

Provide a brief description of activities, programs and services that demonstrate the entity’s role in and commitment to the community:

Provide any other information that demonstrates the community’s need for professional services provided by the entity:

You may attach an annual report or other publication that provides relevant information.