Vendors Disclosure Statements

Chapter 176 of the Local Government Code requires that those who contract with or seek to contract with the Nacogdoches Memorial Health whether they are successful or not, for the sale or purchase of property, goods, or individual or business in their dealings with Nacogdoches Memorial Health must file a “Conflict of Interest Questionnaire” with Nacogdoches Memorial Health. 

The Questionnaire is available for viewing and downloading in PDF from the Texas Ethics Commission: Form CIQ: Conflict of Interest Form and Instructions.

Compliance is the responsibility of each individual, business and agent who is subject to the requirements of Chapter 176, Local Government Code. Should you have questions concerning this matter, please consult your own legal counsel. 

Should you determine that you are required to file a Conflict of Interest Questionnaire, please file it electronically by sending it by e-mail to Nacogdoches Memorial Health. A statement filed electronically satisfies the signature requirement and does not need to be notarized.

Click on Vendor Conflict of Interest Forms below.

Rhonda McCabe - PayCom Conflict Disclosure Statement

James Stockman - YPS Anesthesia Conflict Disclosure Statement

James Stockman - Stockman Pain Services Conflict Disclosure Statement

Patrick Kuhns - Radiology Consultants Conflict Disclosure Statement


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