Michelle Lujan Grisham, Governor

Kari Armijo, Acting Secretary

Nick Boukas, Director, BHSD


Agency Roster Approval

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Approval form

Agency Roster Approval Submission

I, the undersigned, attest that the agents listings - Supervisors and NILs - are complete and accurate

Note - Uploading Supporting Documents

After you click the Submit button below, you will proceed to a page where you can review your input and upload any supporting files.

Please combine all of your supporting documents into one file (preferably a PDF format) and make sure pages are correctly oriented to make review as easy as possible.

After uploading supporting documents (if needed), please complete the document signing.

Thank you!