Hardship Declaration Form - Family Planning / Title X - New Mexico

Hardship Declaration Form - Family Planning/Title X is a legal document that was released by the New Mexico Department of Health - a government authority operating within New Mexico.

FAQ

Q: What is a Hardship Declaration Form?
A: A Hardship Declaration Form is a document used for Family Planning/Title X services in New Mexico to determine eligibility based on income.

Q: What is Family Planning/Title X?
A: Family Planning/Title X is a federal program that provides access to affordable reproductive health services, including contraception, for individuals and families.

Q: Who can use the Hardship Declaration Form?
A: Individuals who are seeking Family Planning/Title X services in New Mexico and believe they meet the income eligibility criteria can use the Hardship Declaration Form.

Q: What information is required on the Hardship Declaration Form?
A: The form will typically ask for personal information such as name, address, income details, and the number of dependents in the household.

Q: Why do I need to fill out a Hardship Declaration Form?
A: The form is used to determine if you meet the income requirements for Family Planning/Title X services and to assess if you qualify for reduced or no-cost services.

Q: Are there any fees associated with Family Planning/Title X services in New Mexico?
A: Fees for Family Planning/Title X services in New Mexico are based on a sliding scale, meaning they are determined based on your income and ability to pay.

Q: How long is the Hardship Declaration Form valid?
A: The validity period of the Hardship Declaration Form may vary, but it is generally valid for a year or until there is a change in your income or household size.

Q: Can I use the Hardship Declaration Form for other assistance programs in New Mexico?
A: The Hardship Declaration Form is specific to Family Planning/Title X services in New Mexico and may not be applicable for other assistance programs.