Nevada Department of Health and Human Services Forms

This form is used for verifying earnings and payroll information for employees in Nevada. It is commonly used by employers to provide accurate wage information to government agencies or other entities.

This Form is used for requesting materials for the Energy Assistance Program in Nevada.

This form is used for designating an authorized representative for the Energy Assistance Program in Nevada.

This form is used for applying for financial assistance in the Energy Assistance Program for individuals with vision impairments in Nevada.

This Form is used for authorizing the issuance of an Electronic Benefit Transfer (EBT) card in Nevada.

This type of document is used for verifying childcare expenses in Nevada.

This Form is used for verifying monetary contributions in Nevada.

This Form is used for applying for Temporary Assistance for Needy Families (TANF) cash benefit programs in Nevada.

This form is used for an addendum to the Nevada Maabd - Emigrant Plan.

This Form is used for applying for assistance in Nevada.

This form is used for submitting additional medical assistance information in Nevada.

This Form is used for reporting changes in Nevada.

Este formulario se utiliza para solicitar un reembolso parental en Nevada.

This form is used for the redetermination of Medicaid eligibility in the state of Nevada.

This form is used for notifying individuals in Nevada of the decision regarding their presumptive eligibility for certain benefits.

This type of document is a Form 2920-EMS Application for Assistance specific to the state of Nevada.

This form is used to apply for presumptive eligibility for Medicaid in Nevada. It allows individuals to receive temporary coverage while waiting for their full Medicaid application to be processed.

This document is used for employers to verify a person's employment and determine any lost wages in the state of Nevada.

This form is used for election to participate in AB 469, a bill in Nevada.