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Ordering Nevada POLST Forms

 

Because the Nevada POLST form is a medical order, Nevada POLST forms are only available to healthcare professionals and medical facilities. Individuals interested in completing a Nevada POLST should contact their physician.

 

The State of Nevada Division of Public and Behavioral Health now provides all state-authorized Nevada POLST forms. The link below will re-direct to their site.

 

Pick-Up or Delivery

  • Pick-up:

    • There is no charge.

    • Locations:

Las Vegas: 4220 S. Maryland Pkwy., Suite 810, Bldg. D, 89119; Phone: 702-486-6515

Carson City: 727 Fairview Drive, Suite E, 89701; Phone: 775-684-1030

Reno: Dini Townsend Hospital, 480 Galletti Way, Building D, Sparks, NV 89431 – Look for the gazebo when approaching from the north at Northern Nevada Adult Mental Health Services campus. Use the main entrance to Dini Townsend and go to the front desk.

  • Delivered

    • You must have a FedEx account number. 

    • Your account will be charged depending on the number of forms ordered.

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Order POLST Forms

  • Click here to order POLST forms. 

  • You will be re-directed to a Nevada Division of Public and Behavioral Health site. This is the entity that provides the forms.

  • Scroll down to "Ordering POLST forms" below the video.

  • Click on the text, "ordered by clicking here."

  • Please also note that the order process includes a short survey.

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For any questions or concerns, please text or call Veneta, the Nevada POLST Chair at 702-788-6787

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