Nevada Department of Health and Human Services Forms

This type of document is a Medical Exemption Certificate for vaccinations in Nevada. It applies to students in Pre-K to 12th grade.

This document is for obtaining a religious exemption certificate for vaccines in daycare centers and childcare facilities in Nevada.

This form is used for obtaining a religious immunization exemption certificate for use in child care or accommodation facilities in Nevada.

This document is a medical certificate of vaccine exception for use in universities in Nevada.

This document is used for parents to obtain a medical immunization exemption certificate for their child in Nevada child care or accommodation facilities.

This document is a medical exemption certificate for vaccines for use in child care centers or daycare centers in Nevada.

This document is a religious immunization exemption certificate specifically designed for use in universities in the state of Nevada. It allows individuals to request an exemption from immunization requirements based on religious beliefs.

This Form is used for submitting applications for a cultural competency training course in Nevada.

This Form is used for authorizing child support payment in the state of Nevada.

This Form is used for requesting prior authorization of Evrysdi (Risdiplam) medication in Nevada.

This form is used for requesting prior authorization for the medication Vyondys 53 (Golodirsen) in the state of Nevada.

This Form is used for requesting prior authorization for Fintepla (Fenfluramine) medication in Nevada.

This form is used for requesting prior authorization for the use of Qutenza (Capsaicin) medication in Nevada.

This document is used for authorizing electronic funds transfers for Nevada Medicaid and Nevada Check Up programs.

This document is an application for a certified birth certificate specifically for a homeless person in Nevada, as per NRS 440.700 (5a).

This Form is used for requesting a correction of a record for a court-ordered name change only in Nevada.

This document is used for applying for a board, commission, or committee in Nevada.

This document is used for obtaining a medical vaccine exemption certificate from universities in Nevada.

This Form is used for entering into a shared responsibility plan agreement in the state of Nevada. It outlines the responsibilities and obligations of the involved parties.

This Form is used for requesting prior authorization for Hereditary Angioedema (HAE) agents in Nevada.

This Form is used for requesting prior authorization for the medication Xywav (Oxybate Salts) in the state of Nevada. It is necessary to fill out this form in order to have the medication covered by insurance.

This form is used for employees in Nevada to report their initial treatment and make a claim for compensation related to a work-related injury or illness.

This form is used for requesting an external review in Nevada. It allows individuals to seek an independent evaluation of a decision made by a state agency or organization.

This document is an application for the Community Based Care Program in Nevada. It is used for individuals seeking assistance with long-term care services and supports in the community.

This document is an application form for the Family Violence Prevention and Services Act (FVPSA) in Nevada. It is used to apply for funding to support programs and services for individuals and families experiencing domestic violence.

This document is a guide for applying for the Family Violence Prevention and Services Act (FVPSA) in Nevada. It provides step-by-step instructions and resources for individuals and organizations on how to access funding and support for programs that address domestic violence and provide services to victims and their families.

This Form is used for notifying the recipient of a lump sum payment in the state of Nevada.