4445
This document is used for reviewing and evaluating physician care in Nevada's Medicaid hospice extended care program. It helps ensure that the care provided meets the necessary standards for Medicaid coverage.
This Form is used for the monthly emergency dialysis case certification in Nevada.
This Form is used for evaluating the functional plan of service in Nevada.
This document is for signing up for presumptive eligibility training in Nevada.
This Form is used for prior authorization of medical services in Nevada. It allows patients to request coverage for certain treatments or procedures.
This form is used for tracking nursing facility activities in the state of Nevada.
This form is used for requesting enrollment in the Behaviorally Complex Care Program in Nevada.
This type of document is a survey form used for collecting feedback from stakeholders of a PCS agency in Nevada.
This Form is used for submitting complaints related to dietitians or music therapists in Nevada.
This form is used for reporting capacity information to the Bureau of Behavioral Health Wellness and Prevention in Nevada. It helps track and monitor the availability of healthcare services related to behavioral health.
This form is used for applying for state prevention certification in the state of Nevada.
This document is an application form for the Zero to Three Infant Toddler Online Lessons in Nevada. It is used for applying to participate in the online lessons for parents and caregivers of infants and toddlers.
This form is used for the renewal approval of an EMS (Emergency Medical Services) course in Nevada.
This Form is used for signing in to the Emergency Medical Systems Program in Nevada.
This Form is used for the Emergency Medical Systems Program in Nevada to create a course roster for students.
This form is used for reporting the completion of an Emergency Medical Services (EMS) course in Nevada.
This document is a checklist for driving instructors in Nevada. It contains important guidelines and requirements that instructors must follow while teaching driving lessons in the state.
This document is for individuals applying to become a driving instructor in Nevada. It includes the necessary forms and information required for the application process.
This Form is used for qualifying emergency management instructors in Nevada.
This document outlines the training standards for the Dem Instructor Program in Nevada. It provides guidelines and criteria for instructors to ensure they meet the necessary qualifications and requirements.
This document is for applying for authorization to operate a continuing education training center for the Emergency Medical Systems Program in Nevada.
This document is used for reporting and monitoring infection control transfers between healthcare facilities in Nevada.
This form is used for obtaining consent to release protected health information (PHI) in the state of Nevada.
This form is used for patients in Nevada to give consent for the release of their protected health information.
This Form is used for obtaining consent to release protected health information for outpatient services in Nevada.
This document form is used for obtaining protected health information in Nevada.
This form is used for determining eligibility and collecting financial information for insurance in the state of Nevada.
This Form is used for referring someone to a program or service in the state of Nevada.
This form is used for completing a gender identity questionnaire in the state of Nevada. It is used to gather information about gender identity for statistical purposes.
This Form is used for collecting racial identity information in Nevada.
This document is a Risk Behavior Questionnaire specific to the state of Nevada. It is used to gather information about risky behaviors of individuals in Nevada.
This Form is used for conducting surveys to determine the eligibility and scope of healthcare providers in Nevada.
This Form is used for the annual client review process in Nevada to determine universal eligibility for various benefits.
This document is a cover page form used for site visits in the Ryan White Part B Program in Nevada.
This Form is used for new clients to apply for universal eligibility for the Nevada Ryan White Parts A, B, C, and D programs. It provides common guidance for completing the application.