How Do I File A Complaint Against A
Licensed Nurse or Nursing Assistant?
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All complaints must be submitted in writing to the Nevada State Board of
Nursing. You may:
- print, complete, and mail the complaint form below;
- click here for a PDF
version of the form;
- obtain a form through the Board
offices in Reno and Las Vegas; or
- submit a signed, written description of
the sequence of events (click here for more information).
The written complaint must be signed by the
complainant. The complaint must include the name of the nurse and a detailed
description of the alleged behavior which violates the Nurse
Practice Act. The complaint should also include any documentation
which supports the complaint, for example a witness statement or
patient record. Complaints can be made by consumers, other regulatory agencies, another
nurse or professional, or anyone with knowledge of the alleged
violation. Some nurses report themselves to the Board and seek
assistance in handling a problem in a way that best protects the
public.
| NRS 632.310 requires that complaint reports be in
writing, signed by the person making the report, and
provide sufficient information and documentation to make
a "prima facie" (face value) complaint.
Documentation may include medical records, personnel
records, signed witness statements or other information
gathered during an internal investigation of the
situation. |
| Nurse/Nursing Assistant Against Whom Complaint Is Made: |
| Location of Incident |
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| Specifics of the Complaint: Please provide a sequential
history of relevant facts. Include dates, patient identification,
nurse behaviors, and documentation supporting your allegation (for
example, copies of patient records, Medication Administration Records
(MARs), statements of other persons involved, description of
confessions, relevant policy and procedures). |
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| Name & Address of Witnesses: |
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| The nurse/nursing assistant named in the allegation has a right
to a copy of the complaint and evidence supporting the allegation once
an administrative complaint has been filed by the Nevada State Board
of Nursing (NRS 632.350). When the Board has rendered a formal
decision, all documents presented before the Board become public
record. |
| Date: |
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| Your Name: |
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| Your Title: |
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| Your Signature: |
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| Facility/Agency: |
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| Address: |
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| Telephone: |
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| Fax: |
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| Email: |
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| If you wish to use this form please print this
page and submit it in person or mail it to the address
given below. |
How do I obtain a complaint report form?
You may print this web page, click here for
a PDF form, call the consumer hot line at
1-888-590-6726, or write:
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Nevada State Board of Nursing
5011 Meadowood Mall Way, #300
Reno, Nevada 89502-6547
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