A New England think tank hopes to be able to gather 10,000 signatures calling for a break-up of the Hunter New England Local Health District.
If the New England Visions 2030 institute is successful in hitting the ambitious goal, it will force a debate in parliament.
Institute convener and founder Maria Hitchcock said a parliamentary debate is the only way to put the issue on the agenda for government.
"We're going to try to encourage people all through the New England and North West to download the paper petition and spread it around the various towns, shops in different places and try to reach out goal," she said.
"Our paper petition goal has to be over 10,000 signatures and we think we can do that quite easily. On top of that will be the Change.Org petition."
Mrs Hitchcock said the health body is "too large", accusing it of taking ownership away from small communities, and treating people in smaller communities as "second-class citizens".
The Armidale-based community group is the latest in a long line of organisations to call for a breakup of the uniquely enormous local health district - which stretches from Tenterfield to Newcastle.
"I really do feel that there is a strong feeling in the community that they want to have some ownership of their medical services and some say," she said.
"We really do need a rural-based area health service. We envisage that the headquarters would be in Tamworth.
"Tamworth being a rural area would have an understanding of the needs of the smaller communities."
Born in 2005, Hunter New England is the only local health district in the state to include a large metropolitan area and a large rural area.
In March, mayors at the New England joint organisation of councils unanimously voted to investigate the option.
The same month, Northern Tablelands MP Adam Marshall called for the sacking of the district's head, if the service didn't make major changes to its operations.
The breakup is also the policy of the National Party, after a vote at the party's June conference.
The petition declares that "centralised decision making has led to an ignorance of what is required in smaller regional communities" resulting in a "lack of adequate services and the requirement for residents to travel long distances to meet their needs".
The institute has set itself a deadline of September 30 to collect all the signatures. It also has an online petition.
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