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NH Department of Health and Human Services (HHS) Bureau of Family Assistance (BFA)BFA Form 777 rev 5/23NH EASY PROVIDER ENROLLMENT Please type or print all information belowOrganization Name: (Maximum
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Submit the completed form to the NH Department of Health either online, by mail, or in person.

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The New Hampshire Department of Health and Human Services (DHHS) is the state agency responsible for public health, health policy, and social services in New Hampshire.
Certain healthcare providers, organizations, and institutions that offer services regulated by the NH Department of Health must file reports and documentation as required by state regulations.
Filling out documents for the NH Department of Health typically involves providing accurate information about healthcare services or conditions, following specific forms and guidelines provided by the department.
The purpose of the NH Department of Health is to protect and improve the health of New Hampshire residents through various initiatives, programs, and regulatory frameworks.
Information that must be reported includes patient data, health outcomes, service provision details, and compliance with health regulations as mandated by state laws.
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