This form is used to return vaccines and to track your inventory. Vaccines that are returned are then cleared from your inventory. Complete and fax this form to the NM VFC Program before you return any vaccines.
The contact information you provided on the Provider Agreement is used by the State VFC Program to communicate alerts, updates, announcements, and reminders. You are strongly encouraged to check your email frequently for updates from the VFC Program.
Use this form to evaluate a steralization provider.
Use this form to report notifiable conditions to the department of health.
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.
Healthcare providers may use this form to order adult vaccines.
Use this form to request general chemistry analysis.
This is the document used to order Naloxone HCI Solution, Narcan Nasal Spray, or Evzio.
This form may be used by adult patients aged 19 and older to provide vaccination consent to a healthcare provider.
This form is used by Healthcare providers to return Adult Vaccines.
Use this form to provide birthing workforce retention fund information to the New Mexico Department of Health.
Fill out this application to apply for admission to the New Mexico State Veterans' Home.
All VFC providers are required to submit this annual VFC certification form in order to continue receiving VFC vaccines.
Interested in NMSIIS training? Please ask your site supervisor to download and complete this form.
Counties: Eddy, Lea, Lincoln, and Roosevelt
Counties: Catron, Dona Ana, Grant, Hidalgo, Luna, Otero, Sierra, and Socorro
Counties: Chaves, Curry, DeBaca, Lincoln, and Quay
Counties: Colfax, Guadalupe, Harding, Los Alamos, Mora, Rio Arriba, San Miguel, Santa Fe, Taos, and Union
Counties: Cibola, McKinley, San Juan, Sandoval, Torrance, and Valencia