New Hampshire Department of Health and Human Services Forms

This type of document is a sample letter of deficiency issued by a Health Officer in New Hampshire regarding septic systems. It outlines the specific problems found with the septic system and provides guidance on how to rectify the issues.

This document is used for submitting a request to add a product to the authorized product list (APL) for the New Hampshire WIC program.

This form is used for fire department inspections in New Hampshire for one and two family dwellings.

This form is used for insurance and safety verification in New Hampshire. It is specifically for Form 1723 (PD20-02).

This document provides a summary of the scoring measures implemented in New Hampshire. It outlines the criteria and methods used to evaluate performance in various areas.

This document is for residents of New Hampshire who are applying for financial assistance for special medical services.

This form is used for the absolute revocation of a CD-Notice in New Hampshire.

This document provides information on anxiety and obsessive/compulsive disorders in children specifically in the state of New Hampshire. It covers symptoms, treatments, and resources available for families dealing with these conditions.

This document is a questionnaire designed for parents in New Hampshire to assess mania, psychosis, and mood disorders in their children.

This Form is used for reporting elevated test results for lead poisoning prevention in New Hampshire homes.

This document is a screening inventory used by parents in New Hampshire to assess traumatic events experienced by their children.

This document is used to record the treatment provided in school-based programs in the state of New Hampshire. It keeps track of the services provided to students and helps in monitoring their progress.

This document provides instructions for reporting progress on Quality Improvement Plan (QIP) for CMHC in New Hampshire.

This letter is to inform parents in New Hampshire about the need for retesting due to a recall.

This Form is used for certifying payment applications for foster care programs in New Hampshire.

This form is used for the certification renewal of private behavioral health services providers in the state of New Hampshire.

This document is an application for accessing the Uniform Healthcare Facility Discharge Data Set (UHFDDS) for public use in the state of New Hampshire. The UHFDDS is a standardized dataset containing healthcare facility discharge data.

This form is used for authorizing the release of protected health and education information to Bfcs in New Hampshire.

This Form is used for extending the Conditional Discharge period in New Hampshire. It allows individuals to continue their probationary period and complete the requirements set by the court.

This form is used for applying for a beverage and bottled water license in New Hampshire.

This document provides updates and changes for the VFC/NHIP vaccine management staff and NHIIS system users in New Hampshire. It contains important information regarding the management and usage of vaccines in the state.

This Form is used for applying for medical assistance in New Hampshire for children, pregnant women, and parent/caretaker relatives.

This form is used for applying for emergency assistance in the state of New Hampshire.

This Form is used for facilitating the safe transfer of patients between healthcare facilities within the state of New Hampshire to prevent the spread of infections.

This form is used for applying for retroactive medical assistance in New Hampshire.

This document provides information and guidelines for WIC customer service self-assessment in the state of New Hampshire.

This document allows you to change your previous decision of not participating in the immunization/vaccination registry of New Hampshire.

This document provides updates and changes related to the NH Immunization Program and NH Immunization Information System in New Hampshire. Keep track of the latest business and practice updates in the state's immunization program.

This form is used for applying for an annual homestead license in the state of New Hampshire.

This document provides an update on the progress of the Quality Improvement Plan (QIP) in New Hampshire. It highlights the efforts being made to improve the quality of services and identify areas for further improvement.

This document is for individuals or companies wanting to apply for a Bulk Milk Hauler License in the state of New Hampshire. The license allows them to transport milk in large quantities.

This type of document allows residents of New Hampshire to choose not to participate in the Immunization/Vaccination Registry.

This form is used for gathering information about a suspected case of rabies in New Hampshire.

This document notifies the termination of the use of confidential data in the state of New Hampshire.

This form is used for authorized users in New Hampshire to document their training, experience, and preceptor attestation for the use of radioactive materials.