Forms

Arbovirus Case Reporting Form Zoonotic Diseases - Form October 14, 2015

Use this form to report cases of West Nile virus to the New Mexico Department of Health.

Animal Test Request Form Biology - Form March 16, 2015

Use this form to request animal specimen analysis.

Report of Audiological Results Form Children's Medical Services - Form December 9, 2014

This form is used by audiologists to report their audiological results to the New Mexico Department of Health after screening a newborn’s hearing.

Fillable Report of Audiological Results Form

Substitute W-9 Form Public Relations - Form August 27, 2014

This form should be used to provide a substitute W-9 form to the New Mexico department of finance and administration's financial control division.

Dairy Analysis Request Form Biology - Form June 9, 2014

Use this form to request dairy analysis.

Pesticide Illness Reporting Occupational Health Surveillance - Form April 2, 2014

This form should be used by all healthcare professionals to report pesticide related illness and injury of workers in New Mexico to the Occupational Health Surveillance Program. It includes a list of questions you can ask your patients and the symptoms of pesticide exposure are also listed in both English and Spanish.

Air Quality Analysis Request Form Air and Heavy Metals - Form March 18, 2014

Use this form to request air quality analysis.

Acknowledgment of Paternity Statement Vital Records - Form February 28, 2014

Establishment of paternity means the establishment of the parent-child relationship. This Acknowledgment of Paternity (AOP) shall be signed under penalty of perjury by the mother and by the man seeking to establish paternity.

Reconocimiento de Paternaty