New Mexico Department of Health Forms

This form is used for conducting hearing screenings in the state of New Mexico.

This form is used for recording the initial health history of a student in New Mexico.

This document is a sample general referral form used in New Mexico. It is used to refer individuals to various services or resources.

This document is used for releasing medical information in New Mexico. It allows individuals to authorize the disclosure of their medical records to a specified recipient.

This form is used for summarizing the screening results of special education nurses in New Mexico. It helps track the qualifications and certifications of these nurses.

This document is used for assessing the health of students in New Mexico schools. It ensures that the students are fit and healthy to participate in school activities.

This form is used for vision screening and referral in the state of New Mexico.

This form is used for obtaining vouchers from the Save Our Children's Sight Fund in New Mexico, which can be used to help cover the cost of eye care and vision services for children.

This document is a performance evaluation tool for non-medical site administrators who work as school nurses in the state of New Mexico. It is used to assess the performance and competency of these administrators in their role as school nurses.

This document is a Diabetes Medical Management Plan specific to New Mexico. It outlines the necessary steps and guidelines for managing diabetes in individuals residing in New Mexico.

This document is used for creating a plan of action and authorizing the use of medication for food allergies, insect allergies, and other emergencies in New Mexico.

This document outlines an emergency care plan for individuals with diabetes in New Mexico. It provides instructions for managing diabetes-related emergencies and should be kept readily available in case of an emergency.

This document is used for notifying healthcare providers about a patient's visit related to asthma or breathing problems in the state of New Mexico.

This Form is used for requesting a medical evaluation for asthma in the state of New Mexico.

This document is a checklist designed for residents of New Mexico to use in case of an asthma emergency. It provides a step-by-step guide on how to manage asthma symptoms and seek emergency medical help if needed.

This document provides information and guidance on how to rescue and treat life-threatening allergies in New Mexico.

This document is used for reporting any incidents related to medication in the state of New Mexico.

This form is used for obtaining parent authorization to administer over-the-counter or short-term prescription medication to a child in New Mexico for a duration of less than 14 days.

This document is used for keeping a record of medication administration in the state of New Mexico.

This document is used for self-administration and self-carry of emergency medication for students with asthma or severe life-threatening allergies in New Mexico.

This Form is used for authorizing emergency health care for students in public schools in New Mexico.

This document allows individuals in New Mexico to grant authorization for medical emergencies.

This document is an Individualized Healthcare Plan for individuals with severe allergies in New Mexico. It outlines personalized medical instructions and accommodations to ensure the individual's safety and well-being in various settings.

This Form is used for obtaining consent for the use of Levonorgestrel (Lng) Intrauterine Device (IUD) in the state of New Mexico.

This form is used to authorize the examination of records and the release of information in the state of New Mexico.

This document is a request for assistance from the regional office in Rora, New Mexico. It is used to ask for help with a specific issue or problem in that area.

This document is used for applying for employment in the state of New Mexico. It helps individuals transition to new job opportunities by providing their personal information, work history, and qualifications to potential employers.

This Form is used for checking radio frequency interference in the Intoxilyzer 8000 breathalyzer device in New Mexico.

This document is used for collecting permission for vaccination at VFC Middle School in New Mexico.

This document provides a quarterly in-person update for Mi via, a company or organization, in New Mexico. It may include information about recent developments, achievements, or changes in operations.

This document is used for applying for reciprocity in the state of New Mexico. It allows individuals to transfer their professional licenses from another state to work in New Mexico.

Este formulario se utiliza para obtener el consentimiento informado de las pacientes que desean utilizar el dispositivo intrauterino (DIU) de levonorgestrel (Lng) en el estado de New Mexico. El formulario proporciona información sobre los riesgos y beneficios del DIU y permite que la paciente exprese su consentimiento para su colocación.

This Form is used for obtaining consent for the Paragard Intrauterine Device (IUD) in the state of New Mexico.

This form is used for obtaining consent from individuals in New Mexico who wish to receive a contraceptive implant.

This Form is used for obtaining consent from adults in New Mexico for receiving vaccinations.