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The intent of this authorization is to give consent for full and complete disclosure of my driver's history, criminal history, educational. You must complete this form when originally hired and when changing child care facilities, being rehired or obtaining a new background check.Carson City, Nevada 89701-4201. Edit, sign, and share Nevada HIPAA Release Form online. You can reach the State of Nevada at 775-684-4177. Governing the legal profession in Nevada since 1928. The State Bar of Nevada is a public corporation that operates under the supervision of the Nevada Supreme Court. I authorize release of the following records (description of specific information to be used or disclosed: i.e. (Please complete all requested information). The medical facility has 30 days to release the requested medical records.