Forms


 NEVADA NURSE PORTAL:

portal

Click the Nurse Portal icon above to submit an application.
For frequently asked questions regarding the Nevada Nurse Portal, click here


PETITION FOR REVIEW OF CRIMINAL HISTORY

A person with a criminal history may submit a petition to the Nevada State Board of Nursing requesting a preliminary determination regarding whether the criminal history will disqualify the person from obtaining a license or certificate. Please click on the link provided below to download the request form. Forward the completed form along with documentation of the criminal history to rmann@nsbn.state.nv.us

Click here to download the request form

You will receive a determination within 90 days of submission



Probation/Monitoring                                                                                        
        AA/NA attendance form          

After Care form                                                 
CNA (initial) supervisor report form          
CNA supervisor report form                    
Licensed Counselor Report                            
Nurse (initial) supervisor report form
Nurse supervisor report form          
Physician report form                                    
Self report form (substance use disorder)
Self report form (practice)                    
Sponsor report form                              
Support group attendance form

Complaint Forms


Complaint report form


Brochures            
                             

Alternative program brochure
         
Consumer brochure                              
Complaint fact sheet for consumers
Complaint fact sheet for nurses and CNAs

Committees



Advisory committee application