Nevada Department of Health and Human Services Forms

This form is used for reporting confidential information related to Latent Tuberculosis Infection (LTBI) in the state of Nevada. It is used to collect important data for monitoring and controlling the spread of LTBI.

This document is a flowsheet used in Nevada for tracking and managing the treatment of Latent Tuberculosis (Ltbi). It includes information on the recommended dosage, monitoring of symptoms, and tracking treatment completion.

This document is for homeless individuals in Nevada who need a certified birth certificate. It is used to comply with the requirements stated in NRS 440.700 (5a).

This document is used to request a certified birth certificate for a homeless child or youth in Nevada, as per NRS 440.700.

This Form is used for designating an authorized representative in Nevada.

This form is used for applying for uninsured medical coverage in the state of Nevada.

This form is used for requesting prior authorization for multiple sclerosis agents in Nevada.

This Form is used for requesting prior authorization for the medication Zelnorm in the state of Nevada.

This Form is used for requesting prior authorization for the medication Sunosi in the state of Nevada.

This Form is used for requesting prior authorization for Nayzilam in the state of Nevada.

This Form is used for applying for a license to distribute dairy products in Nevada.

This document is for reporting providers and third parties in Nevada. It is used to gather information on these entities for regulatory purposes.

This Form is used for health carriers in Nevada to annually report their activities and financial information.

This type of document is used for providing contact information for Health Carrier Navigators, Case Managers, or Facilitators in Nevada.

This document is a manual for parents in Nevada. It provides information and guidance on various topics related to parenting in the state.

This document is a formal request for assistance in the state of Nevada. It is used to seek help or support from authorities or organizations in Nevada.

This form is used for nominating individuals for the Senior Samaritan Award in Nevada.

This document is for residents of Nevada seeking a referral to the Autism Treatment Assistance Program. The program offers assistance and support for individuals with autism and their families.

This document allows residents of Nevada to appoint someone to make health care decisions on their behalf in case they become unable to do so.

This type of document is used for applying to become a mentor in the state of Nevada.

This document outlines a structured plan for professionals in Nevada to enhance their skills and advance their careers. It helps individuals identify goals, map out strategies, and track their progress in professional growth.

This document is used for keeping a record of mentoring activities in the state of Nevada. It helps mentors to track and document their interactions and progress with mentees.

This form is used for making referrals for community based care services in Nevada.

This document describes the role of the Long Term Care Ombudsman in the state of Nevada. It explains their responsibilities and duties in advocating for residents in long term care facilities.

This document is a checklist for obtaining a kingpin approval in Nevada. It provides a step-by-step guide to ensure compliance with the state's regulations.

This document is used in Nevada to notify the successor guardian about the appointment.

This Form is used for requesting prior authorization for Cystic Fibrosis agents in Nevada.

This form is used for requesting prior authorization for sickle cell anemia agents in Nevada.