Forms
NMHSC Stipend Application for 2024 - 2025
Primary Care & Rural Health - Form
July 9, 2024
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.
NMSIIS User Security and Confidentiality Agreement 2025
Immunization - Form
May 22, 2024
NMSIIS User Security and Confidentiality Agreement 2024
NMSIIS Organization Security and Confidentiality Agreement 2025
Immunization - Form
May 22, 2024
Participant organization security and confidentiality agreement for the New Mexico Statewide Immunization Information System.
-9000-Training-Schedule.pdf)
SLD 2025 IR (Infrared) 9000 Training Schedule
Breath Alcohol - Form
April 11, 2024
Use this form to request online training.
Mi Via Administrative Requirements and Interview
Quality Management - Form
March 25, 2024
Mi Via Administrative Requirements and Interview
Mi Via Requirements for Consultants
Quality Management - Form
March 25, 2024
Mi Via Requirements for Consultants
Mi Via Consultant Job Knowledge Interview Survey Tool
Quality Management - Form
March 25, 2024
Mi Via Consultant Job Knowledge Interview Survey Tool
Mi Via Consultant: Participant Specific Interview Survey Tool
Quality Management - Form
March 25, 2024
Mi Via Consultant: Participant Specific Interview Survey Tool
Mi Via Participant Interview Survey Tool
Quality Management - Form
March 25, 2024
Mi Via Participant Interview Survey Tool
Mi Via Participant Agency Record Review Survey Tool
Quality Management - Form
March 25, 2024
Mi Via Participant Agency Record Review Survey Tool
DDW Field Tools - LCA & CI - Administrative Requirement Tool
Quality Management - Form
March 21, 2024
Supports & Services - Administrative Requirement Tool
DDW Field Tools - LCA & CI - Billing Tool
Quality Management - Form
March 21, 2024
Supports & Services - Billing Tool
DDW Field Tools - LCA & CI - Delivery Site Individual Record Review Tool
Quality Management - Form
March 21, 2024
Supports & Services - Delivery Site Individual Record Review Tool
DDW Field Tools - LCA & CI - Healthcare & General Interview Survey Tool
Quality Management - Form
March 21, 2024
Supports & Services - Healthcare & General Interview Survey Tool
DDW Field Tools - LCA & CI - Individual Interview Tool
Quality Management - Form
March 21, 2024
Supports & Services - Individual Interview Tool
DDW Field Tools - COR & CCHS - Direct Service Professionals & Supervisors
Quality Management - Form
March 21, 2024
Supports & Services - COR & CCHS - Direct Service Professionals & Supervisors
DDW Field Tools - COR & CCHS - Internal Service Coordinator
Quality Management - Form
March 21, 2024
Supports & Services - COR & CCHS - Internal Service Coordinator
DDW Field Tools - COR & CCHS - Substitute Care & Respite Personnel
Quality Management - Form
March 21, 2024
Supports & Services - COR & CCHS - Substitute Care & Respite Personnel
DDW Field Tools – LCA & CI - Nurse Interview Survey Tool
Quality Management - Form
March 21, 2024
DDW Field Tools – LCA & CI - Nurse Interview Survey Tool