Fill and Sign United States Legal Forms

This form is used for declaring an abortion under the circumstance of rape in the state of Nevada. It is a legal document that allows individuals to report and certify the occurrence of rape in relation to an abortion.

This form is used for declaring an abortion due to incest in the state of Nevada.

This form is used for submitting an abortion affidavit in cases of incest in the state of Nevada.

This Form is used for individuals who want to enroll as a provider in Nevada. It is the initial enrollment application for providers.

This form is used for provider enrollment applications for ordering, prescribing or referring (OPR) providers in the state of Nevada.

This Form is used for requesting prior authorization for the medication Actemra (Tocilizumab) in the state of Nevada.

This form is used for groups and facilities in Nevada to apply for revalidation as a provider.

This form is used for requesting prior authorization for non-preferred drugs in Nevada.

This Form is used for providers in Nevada to apply for initial enrollment in a group or facility.

This Form is used for requesting prior authorization for Cox-II inhibitors in the state of Nevada.

This Form is used for requesting prior authorization for the medication Amevive (Alefacept) in the state of Nevada.

This form is used for requesting prior authorization for ADHD treatment for recipients aged 18 and above in Nevada.

This Form is used for requesting prior authorization for growth hormone treatment for recipients under the age of 21 in Nevada.

This form is used for requesting prior authorization for ADHD treatment for recipients under the age of 18 in Nevada.

This Form is used for requesting prior authorization for the medication Ampyra in Nevada for individuals with Multiple Sclerosis.

This form is used for requesting prior authorization for the use of topical androgen agents in the state of Nevada.

This Form is used for requesting prior authorization for Makena (Hydroxyprogesterone Caproate Injection) in Nevada.

This Form is used for requesting prior authorization for psychotropic agents for children aged 0 to 5 in Nevada.

This Form is used for requesting prior authorization for psychotropic agents for children and adolescents between the ages of 6 to 18 in Nevada.

This Form is used for requesting prior authorization for the medication Cimzia (Certolizumab Pegol) in the state of Nevada.

This Form is used for requesting prior authorization for targeted immunomodulators in Nevada. It helps ensure that the use of these medications is appropriate and meets necessary criteria.

This form is used for submitting a prior authorization request for the medication Orencia (abatacept) in the state of Nevada.

This form is used for submitting a prior authorization request for the medication Kineret (Anakinra) in the state of Nevada.

This form is used for submitting a prior authorization request for the medication Stelara (Ustekinumab) in the state of Nevada.

This form is used for requesting prior authorization for the medication Remicade (Infliximab) in the state of Nevada.

This Form is used for requesting prior authorization for the medication Cesamet (Nabilone) in the state of Nevada.

This form is used for submitting a prior authorization request for Simponi (Golimumab) medication in Nevada.

This Form is used for requesting prior authorization for an opioid quantity limit in the state of Nevada.

This Form is used for submitting a prior authorization request for Marinol (Dronabinol) medication in Nevada.