Forms
NMSIIS Organization Security and Confidentiality Agreement 2026
Immunization - Form
January 2, 2025
Participant organization security and confidentiality agreement for the New Mexico Statewide Immunization Information System.
1500 Standing Orders CHW Form
Community Health Workers - Form
December 9, 2024
1500 Standing Orders CHW Form
IUD - Aftercare Instructions - Spanish
Family Planning - Form
December 9, 2024
IUD - Aftercare Instructions - Spanish
FY25 Screening and Referral Form (Fillable)
Breast and Cervical Cancer - Form
November 18, 2024
FY25 Screening and Referral Form (Fillable)
FY25 Screening and Referral Form (Fillable)
Breast and Cervical Cancer - Form
November 18, 2024
FY25 Screening and Referral Form (Fillable)
DFA Agency Certification Form
Breast and Cervical Cancer - Form
October 25, 2024
DFA Agency Certification Form
Application for Breast Cancer Awareness Plate
Breast and Cervical Cancer - Form
October 24, 2024
Application for Breast Cancer Awareness Plate
Birth-HBIG Reporting Form
Infectious Disease Epidemiology - Form
October 8, 2024
Birth-HBIG Reporting Form
Pediatric Vaccination Reporting Form
Infectious Disease Epidemiology - Form
October 8, 2024
Pediatric Vaccination Reporting Form
IR-9000 Key Operator Training Request Form
Breath Alcohol - Form
September 10, 2024
Use this form to request online training.
NM J-1 Waiver Application 2025
Primary Care & Rural Health - Form
August 28, 2024
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.
IR-9000 Operator Training Request Form
Breath Alcohol - Form
August 23, 2024
Use this form to request online training.
IR-9000 Field Instructor Training Request Form
Breath Alcohol - Form
August 23, 2024
Use this form to request online training.