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Last Updated: 01/14/09 11:00:52 AM
Nevada Clean Air Indoor Act (Complaint Form)

For filing complaints under the Nevada Clean Air Indoor Act you have three choices. For Southern Nevada use the Southern Nevada Complaint Form , for Washoe County use the Washoe County Smoking Complaint Form ,for all others please complete the form below.

 

Please fill in all fields marked with a *

PERSONAL INFORMATION
 
Last Name*:  First Name*:
 
Address:
 

City: State: Zip:

 
Phone Number*: Email Address:
 

VIOLATION INFORMATION
 
Date Violation Observed*:   Approximate Time Violation Observed:
 

Was a Customer or
Employee Smoking
Yes No

Were No Smoking
Signs Posted
Yes No

Smoking Materials were present
  (ashtrays or matches)
Yes No
 
Name of Establishment*: Establishment County:
 
Establishment Address*:
 
City: State: Zip:
 
Comments:
 
 

 

 
 
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Right Arrow Update to Prenatal Syphilis Screening - SB 304 (2009) New Requirements (pdf)
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Right Arrow Side by Side Comparison of Major Health Reform Bills. Kaiser Foundation (pdf)
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Right Arrow 2009-07-28 - Skilled Nursing Home Healthcare Professionals to Receive an Update on the Minimum Data Set (MDS) at Brown Bag Events in Las Vegas & Carson City (pdf)
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Right Arrow HIV Testing Technical Bulletin (pdf)
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Right Arrow Director of the Department of Health and Human Services Appoints New State Health Officer (pdf)
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Right Arrow Prenatal Syphilis Screening – SB 304 New Requirements, July 1, 2009 (pdf)
Right Arrow CDC's LEAN Works!

 
Lean Works!

 
Right Arrow FDA Issues Warning Pertaining to Zicam
Right Arrow Southern Nevada Area Health Education Centers - Online Training
 Right Arrow WebIZ Users Click Here!
 Right Arrow 5/4/09 – WebIZ Version 8.0
 Right Arrow Complaint Forms, Instructions & Patient Safety Guide (pdf)   
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Recent Publications
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Right Arrow Assigning Tuberculosis (TB)
   Risk Classification in
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   Facilities to Determine
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   (pdf)
Right Arrow J-1 Visa Waiver Program for
   Foreign-born Physicians (pdf)
Right Arrow Office of Statistics /
    Surveillance Newsletter
    (pdf)
Right Arrow Trauma Fact Sheet (pdf)
Right Arrow Nevada Cancer System
    Overview (pdf)
Right Arrow Perinatal Report (pdf)
Right Arrow Early Intervention Impact
    Paper (pdf)
Right Arrow Disinfection and Sterilization
    Technical Bulletin (pdf)
 Right Arrow 2008 Ambulatory Surgical
    Centers Annual Report
    (pdf)
    Click here for questions or
    comments
Right Arrow 2009 Nevada Birth
   Outcomes Monitoring
   System Report (pdf)
Right Arrow 2009-02-27 Nevada
   Academy of Health
   Presentation (pdf) 
 Right Arrow Immunization Report (pdf)
 Right Arrow Infection Control Practices (pdf)
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consumer info
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 Complaints:
 Right Arrow Request Info Form (pdf)
 Right Arrow Clean Air Indoor Act Info
 Right Arrow Clean Air Indoor Act (form)
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Nevada State Health Division
4150 Technology Way
Carson City, NV 89706-2009

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