Please complete all required fields!
Please complete this form regarding your organization’s New Mexico operations. Having a better picture of the characteristics of coalition members gives the Board of Directors and Committees a clearer idea of what would be of most value to members.
Health Care Purchaser
Health Care Provider
Health Support Organization
(please state briefly the business function of your organization)
Approximate number of covered lives:
You may also download the form and mail or email it to us.
The New Mexico Coalition for Healthcare Value is a 501 (c) (3) organization
Tax identification number is 47-3664000