Nevada Department of Health and Human Services Forms

This document is used for creating a financial or medical plan in Nevada. It helps individuals and families in organizing their finances and healthcare options.

This Form is used for the ICPC General Checklist in Nevada.

This document is used to obtain consent for taking and using photographs in the state of Nevada.

This form is used for obtaining a patient's consent for emergency medical, surgical, and dental treatment in the state of Nevada. It outlines the potential risks and benefits of the treatment and ensures that the patient understands and agrees to proceed with the recommended procedures.

This form is used for authorizing correspondence in the state of Nevada.

This Form is used for parents to give permission for their child to participate in activities or events in Nevada.

This document is for obtaining consent for religious participation in the state of Nevada. It ensures that individuals are voluntarily participating in religious activities and that their rights and beliefs are respected.

This form is used for updating information in Nevada's Confidential Address Program (CAP) to protect the privacy of individuals.

This form is used for notifying and waiving the need for hearings in legal proceedings in Nevada.

This form is used for obtaining consent for psychiatric services in Nevada.

This Form is used for obtaining informed consent for medication administration in the state of Nevada. It ensures that the patient understands the potential risks and benefits of the medication.

This form is used for conducting an initial assessment in Nevada. It is specifically applicable to locations in Unity, Nevada.

This Form is used for conducting safety assessments in Nevada. It is a field guide that provides guidance and instructions for assessing safety in various situations.

This document is used to request the approval of a waiver in the state of Nevada. It is commonly used when an individual or organization seeks an exemption from certain requirements or regulations.

This document is used for submitting a request to the Nevada state government for the placement of children through the Interstate Compact on the Placement of Children.

This form is used for reporting on the placement status of a child under the Interstate Compact on the Placement of Children in Nevada.

This form is used for contacting and obtaining consent from the population for the Nytd Follow-Up program in Nevada.

This form is used for the NYTD Baseline survey in Nevada. It gathers information about youth transitioning out of foster care in the state.

This form is used for requesting employee placement in the state of Nevada.

This Form is used for employees in Nevada who are requesting adoption and foster care assistance.

This Form is used for a court jurisdiction survey in Nevada.

This form is used for authorizing the release of confidential information related to children's mental health programs in Nevada.

This document is a grievance form used by the Nevada Division of Child and Family Services (DCFS) to address complaints related to child mental health services.

This document is for the Grievance Resolution Report form in the state of Nevada. It is used to report and resolve grievances or complaints.

This form is used for conducting a universal needs assessment to determine eligibility for 1915(i) services in Nevada. It helps gather information about an individual's needs and supports required for long-term care.

This Form is used for evaluating the eligibility of an individual for adult day health care services in Nevada.

This type of document is used to apply for a Community Paramedicine Provider Endorsement in the state of Nevada.

This Form is used for applying for the Agency Community Paramedicine Endorsement in Nevada.

This Form is used for ensuring Medicaid policy compliance for Residential Treatment Centers (RTC) in Nevada.

This form is used for applying to the Nevada Health Insurance Premium Payment (HIPP) Program.

This document is a form used to apply for the Health Insurance Premiums Payment (HIPP) program in Nevada. The program helps individuals pay for their health insurance premiums.

This form is used for making changes to your managed care organization (MCO) under Nevada Medicaid. The form is available in both English and Spanish.

This document acknowledges the completion of an advance directive in the state of Nevada.

This form is used for civil rights compliance self-evaluation and certification in Nevada. It helps organizations assess their compliance with civil rights requirements and certifies their commitment to equal opportunity.

This form is used for evaluating and certifying compliance with advance directives requirements in Nevada.

This formulario is used for authorization to use and disclose protected health information in Nevada.

This form is used for authorizing the use and disclosure of protected health information in Nevada.

This form is used for Nevada residents who want to request access to or obtain a copy of their protected health information.

This form is used for providing comments and feedback about innovative care services in the state of Nevada.