Emergency Medical System (EMS) - Forms


Trauma Designation

EMS Personnel Change of Address or Information Form

DNR & POLST Information & Forms

General Information:

    Download and save the file to your computer, complete the form, and mail to the Division of Public and Behavioral Health at the address indicated on the form. Please note if utilizing a DNR for Clark County please visit www.southernnevadahealthdistrict.org

      Do Not Resuscitate (DNR):

      Physician Order for Life-Sustaining Treatment (POLST):

        It is preferred that this form be printed on HOT PINK Paper. This is a recommendation and not a requirement. It is also recommended that the completed form be registered with the Living Will Lockbox through the Nevada Secretary of State Office. Information regarding the Living Will Lockbox can be found at www.LivingWillLockBox.com. Please also make sure all medical providers have a copy for their records to ensure that they know your wishes.”

        Emergency Medical System (EMS) Grants


        Emergency Medical System (EMS) - Certification and Licensure


        Certification and Licensing

        EMS Driver Application

        Reciprocity

        Provisional Licensee

        EMS Endorsements

        General Information

        EMS Personnel Change of Address or Information Form

        Last Updated: 10/13/2017