Valley Regional Hospital in Claremont and Dartmouth Health have signed a letter of intent to affiliate, the two institutions announced on Wednesday.

If the affiliation is approved, Valley Regional would join the ranks of several other small hospitals that in the past decade have become part of the giant DH network.

As with previous affiliations, this one requires the approval of the state attorney general’s office.

While not formal affiliates, Dartmouth Health, formerly known as Dartmouth-Hitchcock Health, and Valley Regional have had a close business relationship.

The announcement of its plans with Valley Regional comes three months after DH’s pursuit of a much grander affiliation in southern New Hampshire failed to materialize. New Hampshire Attorney General John Formella rejected the DH’s proposal to merge with Manchester’s Catholic Medical Center. The AG cited concerns the merger would stifle competition in the state’s healthcare marketplace.

CMC has 400 beds. Valley Regional has 25. To begin the affiliation process, officials from both hospitals were to hold an in-person and virtual “public listening session” to discuss the proposal at Sept. 8 in Claremont. — VALLEY NEWS