Nevada Department of Health and Human Services Forms

This Form is used for requesting prior authorization for the medication Wakix (Pitolisant) in Nevada.

This document is a prior authorization request form for Toradol (Ketorolac Tromethamine), a medication used for pain relief. It is specifically for residents in Nevada.

This document is used for registering persons who work without credentials in computed tomography or fluoroscopy in Nevada before January 1, 2020.

This Form is used for registering individuals working without credentials in radiation therapy or radiologic imaging in Nevada prior to January 1, 2020.

This Form is used for registering individuals who hold a license to engage in computed tomography in order to qualify for certification in the state of Nevada.

This form is used for authorizing your employer to release your information to a third party in Nevada.

This document is for the renewal of licenses for Licensed Behavior Analyst (LBA) and Licensed Assistant Behavior Analyst (LABA) in the state of Nevada.

This document is for renewing the registration of a person as a Registered Behavior Technician (RBT) in the state of Nevada.

This Form is used to request prior authorization for antihemophilia agents in Nevada. It helps ensure that patients receive the necessary medications for treating hemophilia.

This form is used for requesting prior authorization for Lupron medication in Nevada.

This form is used for requesting prior authorization for Exondys 51 medication in the state of Nevada.

This Form is used for requesting prior authorization for Spinraza treatment in Nevada.

This Form is used for requesting prior authorization for medications for recipients on hospice in Nevada.

This Form is used for requesting prior authorization for Auvi-Q medication in the state of Nevada.

This document is used for registering rural authorization in the state of Nevada.

This document is used for reporting arbitration claims in Nevada that are worth $5,000 or more.

This document is used for submitting a written statement expressing concerns or complaints regarding grant programs in Nevada.

This form is used for requesting a change of address or other registration changes in the state of Nevada.

This Form is used for requesting prior authorization for the medication called Somavert (Pegvisomant) in the state of Nevada.

This document outlines the plan of care for individuals seeking addiction and recovery services in Nevada under the Comprehensive Addiction and Recovery Act (CARA).

This Form is used for registering the Radiation Control Program for individuals or organizations holding a license to perform Computed Tomography in Nevada for the purpose of qualifying for certification.

This form is used for registering individuals who have been working without credentials in the field of computed tomography or fluoroscopy in Nevada before January 1, 2020, as part of the Radiation Control Program.

This document is a form used for a services agreement in the state of Nevada. It is a legal contract that outlines the terms and conditions between two parties for the provision of services.