Forms
Sterilization – Protocol and Review Form
General information regarding capacity and the designation of a surrogate healthcare decision maker.
Medically Fragile Waiver Registration Form
NMHSC Stipend Program Guidelines for 2023
1915c Waivers Individual Transition Plan Checklist
The New Mexico J-1 waiver program allows foreign medical graduates to obtain a waiver of their 2 year foreign residence requirement in exchange for a commitment to practice in underserved areas of New Mexico after the completion of their training.
EOL1 – Medical Aid in Dying Reporting Form
DD Waiver (HCBS) Application (Spanish)
DD Waiver (HCBS) Application
The New Mexico Health Service Corps provides stipends to eligible health professionals during their last two years of training or residency who, in turn, enter into contract with the Department of Health to provide (when licensed) health service for a minimum of two years (1600 hours per year) in an underserved area of New Mexico. This document is the application for this program.
NMHSC Stipend Applicant Reference Report for 2023
Use this form to confidentially report a case of HIV/AIDS.
This is the application to become an approved Continuing Education Unit Provider.
This is the application detailing required documentation, eligibility requirements, and submission guidelines for Community Health Worker state certification renewal.
Solicitud de Renovación de Certificación Estatal de Trabajadores de Salud Comunitarios
Use this form to request test operator training.
Use this form to request key operator training.
Use this form to cancel training requests.
VFC Provider Staff Change of Contact and uploading Training