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State of Nevada Seal Division of Public and Behavioral Health (DPBH)

Permits

Permits

Application for Agency Community Paramedicine Endorsement
06/02/2016 • .pdf
Community Paramedicine Compliance Agreement
06/06/2016 • .pdf
Agency Renewal Permit Application
05/25/2017 • .pdf
Agency Vehicle Log Form
05/25/2017 • .pdf
Agency Additional Attendants Form
05/25/2017 • .pdf
Driver Only Endorsement Application
05/25/2017 • .pdf
Initial permit
09/01/2017 • .pdf
renewal permit
09/01/2017 • .pdf
Driver program app
11/27/2017 • .pdf
Driver only program app
11/27/2017 • .pdf
Driver only APP
11/27/2017 • .pdf
Permit Application
02/20/2018 • .pdf
CLIA disclosure of ownership
05/17/2018 • .pdf
Permit Renewal App
05/21/2018 • .pdf
Ambulance Service Agreement Form
06/25/2018 • .pdf
Hospital Agreement Form
06/25/2018 • .pdf
Mechanical Safety Form
06/25/2018 • .pdf
Verification of Current Protocols Form
06/25/2018 • .pdf
Variance Review Form
06/25/2018 • .pdf
Physician Director Agreement Form
06/25/2018 • .pdf
FY 19 initial permit app
07/03/2018 • .pdf
FY19 permit renewal
07/24/2018 • .pdf
FY 20 Permit renewal
06/17/2019 • .pdf
Fy 20 initial permit
06/17/2019 • .pdf
FY 20 permit renewal v2
06/17/2019 • .pdf
Letter of Explanation
02/14/2020 • .pdf
volunteer statement
02/14/2020 • .pdf
Statement of Financial Worth
02/14/2020 • .pdf
initial statement of financial worth
02/14/2020 • .pdf
Hospital Agreement 2021
06/29/2021 • .pdf
ASA 9-22
09/20/2022 • .pdf
MSF 9-22
09/20/2022 • .pdf
VCP 9-22
09/20/2022 • .pdf
VRF 9-22
09/20/2022 • .pdf
PDA 9-22
09/20/2022 • .pdf
Nevada Shared Radio System Updates Memo
01/11/2023 • .pdf
Radio Grant Assistance Program
01/11/2023 • .pdf
Radio System Grant Contacts Map
01/11/2023 • .pdf