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State of Nevada
Board of Medical Examiners
Application and Other Licensing Forms
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- Physician Application for
Licensure (Mid-biennial)
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To apply for licensure as an Allopathic Physician (MD) in the state of
Nevada,
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download this printable form (PDF File), which includes detailed instructions.
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- Physician License Renewal (Active Status)
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To apply for registration renewal for the current biennial registration
period
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in the state of Nevada, download this printable form (PDF File), which includes
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detailed instructions.
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- Physician License Renewal (Inactive Status)
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To apply for registration renewal for the current biennial registration
period
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in the state of Nevada, download this printable form (PDF File), which includes
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detailed instructions.
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Physician Application for
Special Purpose Medical License
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(Mid-biennial)
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To apply for licensure as an Allopathic Physician (MD) in the state of
Nevada,
-
download this printable form (PDF File), which includes detailed instructions.
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- Physician
Application for Special Purpose Medical License
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Renewal
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To apply for registration renewal for the current biennial registration
period
-
in the state of Nevada, download this printable form (PDF File), which includes
-
detailed instructions.
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Physician Application for Special
Volunteer Medical License
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To apply for a Special Purpose Medical License in the state of Nevada,
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download this printable form (PDF File), which includes detailed instructions.
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- Physician
Application for Status Change
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To apply for status change from inactive to active status as an Allopathic
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Physician (MD) in the state of Nevada, download this printable form (PDF File),
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which includes detailed instructions.
- Physician
Application for Licensure Reinstatement
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To apply for reinstatement as a Physician Assistant in the state of Nevada,
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download this printable form (PDF File), which includes detailed instructions.
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- Physician
Authorization for Criminal Background
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Investigation
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This form must be completed and submitted with an application for licensure as an
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Allopathic Physician (MD) in the state of Nevada. Download this printable
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form (PDF File), complete, and submit the form with the application.
- Resident
Application for
Limited Medical License
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To apply for licensure as an a Resident in the state of Nevada, download this
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printable form (PDF File), which includes detailed instructions.
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- Physician Assistant Application
for Licensure (Mid-biennial)
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To apply for licensure as a Physician Assistant in the state of Nevada,
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download this printable form (PDF File), which includes detailed instructions.
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Physician
Assistant License Renewal
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To apply for registration renewal for the current biennial registration period
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in the state of Nevada, download this printable form (PDF File), which includes
-
detailed instructions.
- Physician
Assistant Application for Licensure Reinstatement
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To apply for reinstatement as a Physician Assistant in the state of Nevada,
-
download this printable form (PDF File), which includes detailed instructions.
Practitioner
of Respiratory Care Application for Licensure
To apply for licensure as a Practitioner of Respiratory
Care in the state of Nevada,
download this printable form (PDF File), which includes detailed instructions.
- Practitioner
of Respiratory Care Application for Licensure
- Reinstatement
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To apply for reinstatement as a Practitioner of Respiratory
Care in the state of
-
Nevada, download this printable form (PDF File), which includes detailed
-
instructions.
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Notification
of Supervision of Physician Assistant
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To notify the Nevada State Board of Medical Examiners of supervision of
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a Physician Assistant, download this printable form (PDF File).
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- Notification
of Collaboration with Advanced Practitioner
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of Nursing
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To notify the Nevada State Board of Medical Examiners of collaboration with
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an Advanced Practitioner of Nursing, download this printable form (PDF File).
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Notification of Address
Change
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To notify the Nevada State Board of Medical Examiners of change of practice
- address,
download this printable form (PDF File), complete and mail to
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the Nevada State Board of Medical Examiners at P.O. Box 7238,
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Reno, NV 89510-7238.
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- The Nevada State Board of Medical
Examiners utilizes Adobe Acrobat for the distribution of electronic versions of its
documents.
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