If you run out of the forms that were initially supplied with your contract, you may click on the links and print the PDF forms to the right.

Email completed form to:
Monitoring and Probation Investigator
eralph@nsbn.state.nv.us
or
Fax completed form to:
(775) 687-7707 (fax)
Please do not fax multiple copies

• Orientation Attendance
• Attendance at 12 Step Meeting (90 in 90)
• Didactic Instruction Programming
• Process Group Programming
• Individual Counseling Programming
• AA Attendance Meeting (Weekly)
• AA Sponsor Report
• Self-Report (SUD)
• Self-Report (Practice)
• Attendance – Nurse Support Group
• Attendance – After care and/or Individual Counseling
• Licensed Counselor Report
• CNA Initial Nursing Supervisor Report
• CNA Supervisor’s Report
• APRN/RN/LPN Initial Nursing Supervisor Report
• CRNA Initial Nursing Supervisor Report
• CRNA/APRN/RN/LPN Nursing Supervisor’s Report
• APRN Supervisor and Chart Review Report
• Physician/Licensed Practitioner Report