For Nurses and CNAs on Probation or Monitoring Contracts with the Board
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.
Please email, mail or fax the completed forms to:
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
- 90 in 90 AA Meetings
- CNA Initial Supervisor Report
- CNA Supervisor Report
- Didactic Instruction 80 Hours
- Individual Counseling 20 Hours
- Licensed Counselor Report
- Nurse Initial Supervisor Report
- Nurse Supervisor Report
- Physician/Practitioner Report
- Process Group 80 Hours
- Self Report (SUD)
- Self Report (Practice)
- Sponsor Report