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COMMUNITY BENEFITS REPORTING FORM Pursuant to RSA 7:32cl FOR FISCAL YEAR BEGINNING 01/01/2013 to be filed with: Office of the Attorney General Charitable Trusts Unit 33 Capitol Street, Concord, NH
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Begin by gathering all necessary personal information, such as full name, date of birth, address, and contact details.
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Provide information about your current healthcare coverage, if applicable, including the name of the insurance provider and policy number.
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Specify any dependents that need to be included in the application, providing their full names and dates of birth.
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Answer all questions regarding your household income, employment status, and any government assistance programs you may be enrolled in.
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Submit the application through the designated channels, such as mail, in person, or online. Follow any additional instructions provided by Coos County Family Health.

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Coos County residents who are uninsured or underinsured and in need of affordable healthcare services.
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Anyone in Coos County who values accessible and affordable healthcare options for themselves and their family members.
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Coos County Family Health is a program that provides health services to families in Coos County.
All families living in Coos County are required to file Coos County Family Health.
You can fill out Coos County Family Health by visiting the official website and following the instructions provided.
The purpose of Coos County Family Health is to ensure that families in Coos County have access to essential health services.
You must report your family's demographic information and any health concerns or needs.
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