Nevada Department of Health and Human Services Forms

This form is used for applying for a birth certificate in the state of Nevada.

This document is used for establishing legal paternity in the state of Nevada. It is a form that allows a man to declare himself as the father of a child and establish his rights and responsibilities.

This form is used for screening the health of established patients, including babies and children, in Nevada's Healthy Kids program.

This form is used for the initial screening of new patients in Nevada's Healthy Kids (EPSDT)/Well Baby/Well Child program.

This form is used for obtaining physician orders for life-sustaining treatment in Nevada. It allows individuals to specify their preferences regarding medical interventions.

This form is used for evaluating an EMS course in the state of Nevada.

This form is used for tracking temperature logs in the Nevada State Immunization Program. It ensures that vaccines are stored at the appropriate temperature to maintain their effectiveness.

This document is for applying for a Do-Not-Resuscitate Identification in Nevada for adults.

This document is used for applying for a Do-Not-Resuscitate (DNR) identification for a minor in the state of Nevada. The DNR identification allows medical professionals to honor a patient's wishes to not be resuscitated in the event of cardiac arrest or other life-threatening situations.

This Form is used for employee training in the state of Nevada. It collects necessary information and tracks the training progress of employees.

This document is a listing of employees or residents in the state of Nevada. It provides important information about individuals living or working in Nevada.

This document is a record of fire drills that have taken place in Nevada. It contains information about when the drills were conducted, who participated, and any observations or findings from the drills. This record helps to ensure that proper safety procedures are being followed in case of a fire emergency.

This form is used for recording and documenting substantiated complaints in Nevada.

This document is used for keeping track of transportation activities and movements in the state of Nevada. It includes information about vehicles, drivers, routes, and any relevant details pertaining to transportation operations.

This document is used for keeping a record of carpet cleaning activities in the state of Nevada. It helps to track the cleaning schedule and maintenance of carpets in homes, offices, or other establishments.

This form is used for reporting cases of abuse or neglect in the state of Nevada. It allows individuals to notify the authorities about any suspected mistreatment or harm that someone may be experiencing.

This document provides a list of emergency phone numbers for residents in Nevada. It includes numbers for police, fire department, ambulance services, and other important local emergency contacts.

This document is used to obtain a permit for a field trip in the state of Nevada. It is necessary for schools and organizations to ensure they have the proper authorization for educational outings.

This document is used for declaring one's health condition in the state of Nevada. It may be required for various purposes such as employment, insurance, or participation in certain programs.

This document is used for requesting medication in the state of Nevada. It provides a written record of the requested medication and helps ensure that the patient receives the appropriate treatment.

This form is used for granting permission to release personal information in the state of Nevada. It allows individuals to authorize the disclosure of certain information to designated parties.

This form is used for employees to sign in and out of their shifts in Nevada. It helps track attendance and monitor hours worked.

This form is used for Nevada Medicaid recipients to create a Functional Assessment Service Plan.

This Form is used for creating a Functional Assessment Service Plan for individuals receiving Medicaid in Nevada.

This form is used for requesting dental history information in the state of Nevada.

This Form is used for requesting medical equipment and vision history in Nevada.

This form is used for tracking ICF/IID services in Nevada for individuals with intellectual and developmental disabilities.

This document provides guidelines for conducting EPSDT screening in Nevada. It outlines the process and requirements for healthcare providers to follow when performing these screenings on eligible children.

This form is used for giving consent to an alcohol or drug test in the state of Nevada. It is necessary for certain jobs or legal situations.

This document is for landlords in Nevada to acknowledge their responsibilities related to handling radioactive materials.

This form is used to request reciprocity authorization in the state of Nevada.

This document contains a checklist of requirements for obtaining a license for industrial radiography in Nevada. It outlines the necessary steps and documentation needed to ensure compliance with state regulations.

This document is a checklist used in Nevada for licensing portable gauges. It provides information on the requirements and steps needed to obtain a license for portable gauge operations in the state.

This document provides a checklist for laboratories in Nevada to ensure they meet the necessary licensing requirements.

This document is a checklist for veterinarians in Nevada to guide them through the process of applying for a new or renewal veterinary license.

This document is for verifying the completion of RSO/Gauge User Training in the state of Nevada. It helps ensure that individuals have received the necessary training to safely handle and operate radiation equipment.

This document delegates authority to a Radiation Safety Officer in Nevada. It is used to establish responsibilities and ensure compliance with radiation safety regulations.

This document provides the process for granting authority to individuals other than the Radiation Safety Officer (RSO) in Nevada to amend and renew licenses related to radiation safety.