How to Become a Member

New Hampshire Hospice and Palliative Care Organization
125 Airport Rd, Concord, NH 03301 603-415-4298 info@nhhpco.org

... improving access to quality care for New Hampshire residents with life-threatening conditions

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NH Providers

NH Pain Initiative

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Contact Info

About NHHPCO

About Hospice & Palliative Care

Advance Directives

Best Practices

Education Events and Conferences

Employment

Golf Tournament

Hospice & Palliative Care Providers and Hospice House Facilities

How to Make a Donation

How to Join or Renew Membership

Journey Home Thrift

Member News

Networking Meetings

NH Pain Initiative

NHHPCO Fall Conference

Newsletter

Palliative Care

Regulatory

Resources

Ride to Remember

Volunteer News

Please Join With Us or Renew Existing Membership Today		DOWNLOADS
	�	SUSTAINING MEMBERSHIP APPLICATION
	�	INDIVIDUAL MEMBERSHIP APPLICATION & RENEWAL FORM
	�	PALLIATIVE CARE MEMBERSHIP APPLICATION Form
	�	Credit Card Authorization Form

Individual Membership Includes volunteers, board members, individual hospice staff members and other individuals who have an interest in hospice and palliative care. There are two types of Individual Members:

Individual Member
Dues are $50/year

Sustaining Member:

Platinum Sustaining Member--$1000 is acknowledged by Bronze Sponsorship
    at one major NHHPCO event per year, two complimentary registrations to the
    annual conference, opportunity to include an article promoting products and/or
    services in one issue of The Bridge and acknowledgement of membership on
    the NHHPCO website.
Gold Sustaining Member--$500 is acknowledged by exhibit space at one
    NHHPCO event per year, one complimentary registration to the annual
    conference, and acknowledgement of membership on the NHHPCO website.
Silver Sustaining Member--$250 Includes one registration to the annual
    conference, and acknowledgement of membership on the NHHPCO website.

Provider Membership There are two types of Provider Members, either of which can elect to be a Patron:

Hospice Provider Members are state licensed agencies or programs providing hospice care. Provider
    Members have voting responsibilities and privileges. Membership dues are $200 plus $3.50 per
    patient served in the prior year. Please request membership form from Janice McDermott at
    jmcdermott@nhhpco.org

Palliative Care Provider Members are any public or private agency, entity, center, institution or
    part thereof, providing palliative care and recognized by a healthcare institution as a distinct
    palliative care program. Hospice-based palliative care programs in the developmental stage would be
    considered palliative care providers. Annual membership dues are $300.

Patron Provider Members are Hospice Provider Members or Palliative Care Provider Members who
    wish to support NHHPCO at a higher level with the following added benefits. Please request
    membership form from Janice McDermott at jmcdermott@nhhpco.org

Platinum Patron: $10,000.00 Annual Conference Platinum sponsor, six complimentary registrations to
    annual conference, logo on NHHPCO website, golf sponsor with one complimentary team.

Gold Patron: $7,500.00 Annual Conference Gold sponsor, four complimentary registrations to annual
    conference, golf sponsor with one complimentary team.

Silver Patron: $5,000.00 Annual Conference Silver sponsor, two complimentary
     registrations to fall conference.

Please contact us if you have any questions at jmcdermott@nhhpco.org or 603-415-4298

4	SPOTLIGHT on Educational Opportunities Around the State and Surroundings DETAILS HERE

DONATIONS - Information available HERE

Please take time to join or renew existing membership with NHHPCO now.

To Join or Renew Membership
Download PALLIATIVE CARE MEMBERSHIP APPLICATION and
INDIVIDUAL MEMBERSHIP/RENEWAL Form
Please download and PRINT for mailing to:
The New Hampshire Hospice and Palliative Care Organization
125 Airport Rd, Concord, NH 03301

If you are unable to download these forms, please email us at info@nhhpco.org
and we will send it to you in the mail.

Please contact us at info@nhhpco.org if you are having difficulties with download.

Membership
2010
Hospice Provider Members
These programs are members of and support the State Organization for Hospice and Palliative Care

� Amedisys Hospice of Londonderry,
   Londonderry, NH
� Amedisys Hospice Services of
   Portsmouth, Portsmouth, NH
� Androscoggin Valley Hospital Home
   Health & Hospice Services, Berlin, NH
� Beacon Hospice, Concord, NH
� Community Health & Hospice,
   Laconia, NH
� Concord Regional Visiting Nurse
   Association and Hospice House,
   Concord, NH
� Connecticut Valley Home Care
   Hospice, Newport, NH
� Home Health & Hospice Care,
   Nashua, NH
� Lake Sunapee Region VNA &
   Hospice, New London, NH
� Merrimack Valley Hospice,
   Lawrence, MA
� Pemi-Baker Home Health & Hospice,
   Plymouth, NH
� Rockingham VNA & Hospice, Exeter,
   NH
� SolAmor Hospice, North Hampton, NH
� St. Joseph Home & Hospice Care,
   Nashua, NH
� Visiting Nurse Association & Hospice
   of Franklin
� VNA Home Health & Hospice Service,
   Inc., Exeter, NH
� VNA Home Health & Hospice
   Services, Inc, Manchester, NH
� VNA & Hospice of So. Carroll County
   &Vicinity, Wolfeboro, NH
� VNA & Hospice of Vt. & NH,
    W. Lebanon, NH

2010
Palliative Care Provider Members
These programs are members of and support the State Organization for Hospice and Palliative Care

� DHMC Palliative Care Service,
   Lebanon, NH
� Lakes Region General Hospital,
   Laconia, NH
� The New Hampshire Palliative Care
   Service, Portsmouth, NH

2010
Patron Provider Members
These are Hospice Provider or Palliative Care Provider Members who wish to support NHHPCO at a higher level.

Platinum Patron $10,000.00

Gold Patron $ 7,500.00

Silver Patron $ 5,000.00

2010
Sustaining Members
NHHPCO recognizes with gratitude the financial support given by its sustaining members which enables the work of the organization to be extended.

Platinum Sustaining   $1,000.00

� HCS Home Care Specialists,
   Haverhill, MA; Concord, NH; and
   Eliot, ME

Gold Sustaining $ 500.00

� Dan Perkins, Comfortcare HME,
No. Chelmsford, MA

Silver Sustaining $ 250.00

� Foundation for Healthy Communities
� Mary Catherine Gennaro
� Madeline Gerken
� Andrea Huertas
� Wilkinson-Beane-Simoneau-Paquette
Funeral Home & Cremation Services

This page was last updated December 08, 2010

This NHHPCO website is designed and maintained entirely through volunteered services.
� 2005-2009 New Hampshire Hospice and Palliative Care Organization

Please Join With Us or Renew Existing Membership Today

Please Join With Us or
Renew Existing Membership Today