Lupus Reporting Form

Pursuant to NRS 439.4976, establishment of a system of reporting information on lupus and its variants. The State of Nevada has established a system of reporting for lupus and its variants to conduct comprehensive epidemiologic surveys and to evaluate the appropriateness of measures for the treatment of lupus and its variants within the state of Nevada.

Hospitals, medical laboratories, and other facilities provide screening, diagnostic or therapeutic services to patients with respect to lupus and its variants shall report the information pursuant to NRS 439.4978 each report must include, without limitation:

1. The name, address, age, and ethnicity of the patient.
2. The variant of lupus with which the person has been diagnosed.
3. The method of treatment, including, without limitation, any opioid prescribed for the patient has adequate access to that opioid.
4. Any other diseases from which the patient suffers.
5. If a patient diagnosed with lupus and its variants dies, his or her age of death.

To access the Lupus Reporting Form, click the “download PDF” button.