Do not resuscitate form nevada 2026

1. Click ‘Get Form’ to open the Do-Not-Resuscitate Identification Application in our editor.
2. Begin by filling out the ‘Patient Information’ section. Enter your name, address, phone number, birthdate, and gender accurately.
3. In the ‘Patient’s Statement’ section, confirm your decision regarding life-resuscitating treatment by signing and dating the form.
4. If applicable, have your agent complete their section by providing their name, address, and signature.
5. Next, ensure your attending physician fills out the ‘Attending Physician’s Statement’ with their details and signature.
6. Include a check or money order for $5 made out to the Nevada State Health Division with your completed application.
7. Finally, mail the application to the specified address: Emergency Medical Services, 4150 Technology Way, Suite 101, Carson City, NV 89706.

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