New Hampshire Department of Health and Human Services Forms

This document provides information about the Child Care Licensing Unit in New Hampshire. It outlines the regulations and requirements for licensing child care facilities in the state.

This document is required for admission to Glencliff Home in New Hampshire.

This document for planning final arrangements in the state of New Hampshire. It provides guidance and information on making funeral and burial arrangements in accordance with New Hampshire laws and regulations.

This document is an inspection report for a youth recreation camp in New Hampshire. It provides details and evaluations of the camp's facilities, safety measures, and overall compliance with regulations.

This document provides a summary of the financial activities and position of the state of New Hampshire. It includes details about revenues, expenditures, assets, and liabilities.

This document is used for applying for a placement opportunity in the state of New Hampshire.

This form is used for authorizing the release of information from the New Hampshire Division for Children, Youth and Families (DCYF) Central Registry to a third party for conducting a name search. It allows the third party to access information about individuals listed in the registry.

This document is a functional screen QA checklist specific to the state of New Hampshire. It is used to ensure that all necessary functions and features of a packet are properly tested and functioning correctly.

This document is a functional screen used in New Hampshire for determining eligibility for waiver services.

This document provides guidance and instructions for the Child & Infant WIC Program in New Hampshire. It includes information on eligibility criteria, benefits, and how to apply.

This type of document is used for obtaining emergency certification for small community residences with three or fewer beds in the state of New Hampshire.

This document is used for submitting veterinary specimens in New Hampshire. It is required when sending samples to the veterinary laboratory for testing and analysis.

This form is used for reporting and investigating housing complaints in New Hampshire. It is typically used by a health officer to document and address issues related to unsafe or unsanitary living conditions.

This Form is used for authorizing the disclosure of protected health information at New Hampshire Hospital in New Hampshire.

This Form is used for requesting authorization for environmental modification in the state of New Hampshire.

This Form is used for submitting a six-month nurse trainer report to the NH Bureau of Developmental Services Medication Committee for programs without reportable errors in New Hampshire.

This document is used for patients in New Hampshire to request prescription drug monitoring information.

This form is used for documenting and reporting cases of pediatric HIV/AIDS for patients who are 13 years of age in the state of New Hampshire.

This form is used for conducting a home health inspection as part of the process to obtain a foster family care license in the state of New Hampshire. It ensures that the home meets the necessary safety and health standards for caring for foster children.

This form is used for requesting permission to use encapsulant paint in the state of New Hampshire. Encapsulant paint is a type of paint that seals in hazardous materials, such as lead paint, to prevent them from becoming airborne and causing health risks.

This form is used for requesting permission to continue using confidential cancer data in the state of New Hampshire.

This form is used for notifying the state of New Hampshire about work being conducted. It is used to provide information about the nature of the work and its location.

This Form is used for requesting the use of abatement alternatives in New Hampshire.

This Form is used for the Sysc Prea Employment Questionnaire in the state of New Hampshire.

This form is used for creating a tenant roster in the state of New Hampshire. It helps landlords keep track of their tenants and their contact information.

This type of document is used for implementing a Hazard Analysis Critical Control Points (HACCP) system in New Hampshire.

This Form is used for attesting that there is no price reporting for Prescription Drug Acquisition Costs in New Hampshire.

This Form is used for the Work Experience Program (WEP) Agreement in the state of New Hampshire.

This document is a Cell Phone Usage Agreement for Breastfeeding Peer Counselors in New Hampshire. It outlines guidelines and expectations for cell phone usage while working in this role.

This form is used for submitting a six-month report on medication usage by provider agencies to the NH Bureau of Developmental Services Medication Committee in New Hampshire.

This Form is used for requesting NH Ryan White Care in New Hampshire.

This document is for withdrawing and removing information from the New Hampshire Immunization/Vaccination Registry in Arabic.

This form is used for requesting emergency assistance in New Hampshire. It is specifically designed for Spanish-speaking individuals.

This document provides a job search form for the Employment and Training (SNAP E&T) program under the Supplemental Nutrition Assistance Program (SNAP) in New Hampshire.

This document is used for registering immunization/vaccination in New Hampshire for Spanish speakers.