Please contact us at nvpco@health.nv.gov if you have any questions, trouble accessing any of the forms/instructions, issues with any of the formatting, notice any errors, or have suggestions for improvement.
Information, Instructions & Forms
Instructions for submitting an application
J-1 Informational Flyer
Employer and Physician to submit Application Attestation form at time of application.
Complete a New Arrival form upon start date.
Upon starting, both the Sponsors/Employers & Physicians participating in the Nevada Conrad 30 J-1 Visa Waiver Program are to read through the Rights and Responsibilities presentation, understand and acknowledge their Rights and Responsibilities.
Complete Physician and Employer Compliance form semi-annually. Each April and October for the prior six-month period all employers of physicians practicing medicine in the State of Nevada under a J-1 Visa Waiver supported by the Nevada Division of Public and Behavioral Health (DPBH) are required to confirm that the physician is providing a minimum of 40 hours a week of primary care in a practice site(s) located in an underserved area.
Change of Status Forms
A change of status form to be completed and approved by DPBH when there would be a change in Practice Location, Provider Discipline or Employer.
Application to request a variance with the Nevada State Board of Health for any person who, because of unique circumstances, is unduly burdened by a regulation of the State Board of Health and thereby suffers a hardship and the abridgement of a substantial property right may apply for a variance from a regulation. NAC 439.200(1).