Nevada Department of Health and Human Services Forms

This document outlines the individual work plan for participants in Nevada's Infant-At-Work Program. It provides details on the tasks and responsibilities assigned to each participant.

This Notice of Intent is used in Nevada to inform employees about their rights to break times and a designated place to express milk at work.

This type of document is a "Request for Assistance - Nevada" form in Spanish.

This Form is used for referring individuals to the Early Intervention Program in the Northern Region of Nevada.

This Form is used for referring individuals to the Early Intervention Program in the Southern Region of Nevada.

This document is used for requesting emergency services for victims of human trafficking in Nevada through the Contingency Account for Victims of Human Trafficking (VHT).

This document is used for registering for the Tax Assistance Program in the state of Nevada.

This document is for applying for Medicaid specifically for individuals who have aged out of foster care in the state of Nevada. Apply for healthcare coverage through Medicaid with this form.

This document is used to authorize the release of an infant from a healthcare facility in Nevada.

This Form is used for applying for financial assistance under the Family Violence Prevention and Services Act (FVPSA) and the Coronavirus Aid, Relief, and Economic Security (CARES) Act in Nevada.

This document is used to assess the needs and strengths of children and adolescents in Nevada. It helps identify the support and services they may require.

This document for creating a financial and medical plan in the state of Nevada. It helps individuals plan and organize their finances as well as outline their medical needs and preferences.

This form is used for changing information in Nevada's Confidential Address Program, which allows eligible participants to keep their address confidential.

This form is used for notifying individuals about a hearing and obtaining their waiver in the state of Nevada.

This form is used for caregivers in Nevada to provide notice of a hearing.

This form is used for notifying the court and other parties about the appointment of a successor guardian in Nevada.

This form is used for notifying the Kinship Guardianship Assistance Program (Kingap) in Nevada.

This form is used for the approval checklist of a Nevada Kingap in Nevada.

This document is used for collecting data elements and outcomes through a survey in Nevada.

This form is used for obtaining informed consent for the administration of medication in the state of Nevada.

This document is used to authorize the release of confidential information in Nevada.

This form is used for reporting civil rights and privacy incidents in Nevada.

This Form is used for conducting neuropsychological testing in Nevada. It helps assess cognitive abilities and diagnose neurological conditions.

This document is used for collecting feedback from small businesses in Nevada regarding the potential impact of proposed regulations on their operations. It aims to assess the effects on small businesses and gather their input on the regulations.

This form is used for renewing the certification of Detoxification Technicians in Nevada.

This form is used for filing complaints related to environmental health issues in Nevada. It allows residents to report concerns regarding air quality, water pollution, hazardous waste, and other environmental hazards.

This form is used to request a standing order in the state of Nevada. A standing order allows for automatic, recurring payments to be made to a specific recipient.

This document is a questionnaire used in Nevada to gather information from subrecipients.

This document is used for applying for a variance in the state of Nevada. A variance is a request to deviate from specific zoning or land use regulations.