New Hampshire Department of Health and Human Services Forms

This document is used for registering a child for childcare in the state of New Hampshire and providing emergency contact information.

This form is used for household and personnel information in the state of New Hampshire.

This document is for obtaining a certificate of religious exemption for immunizations in a child care program in the state of New Hampshire.

This document is used to verify the zoning regulations for a property located in New Hampshire. It provides information on land use restrictions, building codes, and other zoning requirements.

This document is a staff and household list for residents in New Hampshire. It includes information about individuals who work in the household and their roles, as well as other members of the household.

This document is a sworn statement that is required under the RSA 170-E 29-A, III law in the state of New Hampshire.

This form is used for verifying a remote learning center in New Hampshire. It helps ensure that the center meets the necessary criteria for providing quality education remotely.

This document is used for reporting injuries or incidents that occur in the state of New Hampshire. It helps gather information about the incident and any resulting injuries for documentation and potential legal purposes.

This form is used for authorizing a search of the New Hampshire Child Abuse and Neglect Central Registry for a person's name.

This Form is used for providing information about staff and household members in New Hampshire.

This document is used for applying for residential child care in the state of New Hampshire. It is required for individuals or organizations looking to provide care for children in a residential setting.

This document is a compliance report for the New Hampshire State Fire Code. It is used to assess the adherence to fire safety regulations in the state.

This document is for Health Officer Inspection Report for Residential Child Care Agencies in the state of New Hampshire. It provides an assessment of the health and safety conditions in such facilities.

This form is used for child care personnel to report their health status in the state of New Hampshire.

This form is used for reporting incidents that occur in residential child care facilities in New Hampshire. It helps to document and investigate any incidents that may have occurred involving the children in care.

This document is used for collecting information about personnel working in residential child care facilities in New Hampshire. It helps to ensure the safety and well-being of children in these facilities.

This form is used for claiming paternity in New Hampshire. It is called the DCSS s682 Claim of Paternity Affidavit.

This document is for conducting an assessment of a child care facility during a licensing visit in New Hampshire. It is used to evaluate the compliance of the facility with state regulations and ensure the safety and well-being of children in care.

This form is used for requesting a change of address in the Putative Father Registry in New Hampshire.

This document is an application form for the New Hampshire State Loan Repayment Program. Residents of New Hampshire can use this form to apply for financial assistance to repay their loans.

This document is used to confirm the employment details of behavioral health providers under post-graduate supervision in the state of New Hampshire.

This type of document is used in New Hampshire to apply for medical assistance for children, pregnant women, and parent/caretaker relatives.

This document is used for applying to continue a contract in the New Hampshire State Loan Repayment Program.

This document provides information on the use of cloth face coverings to prevent the spread of COVID-19 in New Hampshire.

This Form is used for creating a general contract agreement in the state of New Hampshire.

This document provides guidance for the reopening of businesses and activities in New Hampshire during the Covid-19 pandemic. It includes information on safety measures, capacity limits, and other guidelines to prevent the spread of the virus.

This form is used for calculating child support payments in the state of New Hampshire.

This Form is used for registering radiation or magnetic resonance imaging machines in New Hampshire.

This document for requesting special formula and authorization for WIC supplemental foods in the state of New Hampshire.

This form is used for reporting income earned in the state of New Hampshire for tax purposes. It is an alternative version of the standard W-9 form for residents of New Hampshire.

This form is used for requesting reimbursement for transportation expenses in the state of New Hampshire.

This document is used for keeping a daily record of the use of restricted use pesticides (RUP) in New Hampshire. It helps track and monitor the application of these pesticides to ensure compliance with regulations and protect public health and the environment.

This form is used for reporting concerns related to communication access in the state of New Hampshire. It allows individuals to bring attention to any issues or barriers they may have encountered in accessing communication services or information.

This document is for requesting an appeal in the state of New Hampshire. It is used to ask for a review or reconsideration of a decision made by a government agency or court.

This form is used for attestation of requirements and authorization to pay one-time for a supplemental recruitment, retention, and training payments in New Hampshire.

This Form is used for attesting requirements and authorizing a one-time payment for recruitment, retention, and training in New Hampshire.