How will my health care provider know if I
have an Advance Directive in the Lockbox?
It is important to notify family members and
health care professionals that you have an
advance directive filed in the Nevada Lockbox.
Share your wallet card registration number with
your loved ones, attorney, and/or health care
professionals. Be sure to let them know of any
updates in your documents ranging from a simple
change of address to a new advance directive. As
the registrant, you are responsible for ensuring
that your registration number is shared only
with people that you want to have access to your
Lockbox file.
How can my health care provider or health
care facility become an Authorized Entity?
An Authorized Entity may access the Lockbox
through their own registration access or by using
the patient’s registration number if the patient is
able to provide it. Authorized entities have secure
access to the registry and can immediately
determine if a patient has an advance directive or
other related document registered with the
Advance Directive Registry, thus enabling them
to access that patient’s advance directive.
In order to be an Authorized Entity,
organizations must complete and submit the
Authorized Entity Access Agreement to the
Nevada Secretary of State’s office. Agreements
will only be accepted from those organizations
licensed to conduct business in Nevada and that
hold an active medical provider license. Once
approved, the Lockbox program will contact the
Authorized Entity with instructions, an account
number and access code.
NEVADA LOCKBOX
Nevada Secretary of State
2250 Las Vegas Boulevard North, Suite 400
North Las Vegas, NV 89030
www.NevadaLockbox.nv.gov
For more information contact:
Program Officer: 702-486-2887
Secure Fax: 775-684-7177
Email: Lockbox@sos.nv.gov
A GUIDE TO
THE FILING AND
ELECTRONIC
STORAGE OF
ADVANCE
DIRECTIVES
AND
GUARDIANSHIP
NOMINATIONS
A no-cost service provided by
Nevada Secretary of State
NevadaLockbox.nv.gov
Protecting Your Wishes
How do I register with Nevada Lockbox?
You can obtain an Advance Directive
Registration Agreement and/or a Request to
Nominate Guardian Form online at
www.NevadaLockbox.nv.gov. Mail, fax, or
hand deliver a signed registration agreement
along with copies of your advance directive to:
Nevada Lockbox
c/o Nevada Secretary of State Barbara Cegavske
2250 Las Vegas Boulevard North, Suite 400
North Las Vegas, NV 89030
Fax: 775-684-7177
The original Request to Nominate Guardian
Form with wet signatures is required and may be
mailed or hand delivered (do not fax). If you do
not have computer access, these forms can be
mailed to you by calling the program office.
You will receive a
letter confirming
your registration
and that the
documents have
been securely
stored. Your
confirmation letter
will also include a wallet-sized card containing
your registration number along with adhesive
labels with Nevada Lockbox contact information,
instructions for accessing your Lockbox and
viewing documents online, and how to make
changes.
Can I make changes to my Lockbox?
As the registrant, you may update your
registration at any time using an Authorization to
Change Form. You may also replace, withdraw,
or revoke all or part of your documents filed with
the Nevada Lockbox. A new Request to
Nominate Guardian Form will be required if you
are changing a nominee as your guardian.
Changes to your Nevada Lockbox must be in
writing using the appropriate form.
What is the Nevada Lockbox?
The Nevada Lockbox is an electronic registry
securely maintained on the Nevada Secretary of
State website, which contains an electronic
reproduction of each document filed by the
registrant. Documents are readily available
online when needed. The Nevada Lockbox has
two filing components: the Advance Directive
Registry and the Guardianship Nomination
Registry.
Which documents can I file?
An advance directive is a document in which you
provide instructions about your health care
wishes when you are physically or mentally
unable to express them. It is called an advance
directive because you make the medical decision
for yourself before you become seriously ill.
Some examples of advance directives include:
✓ Living Wills
✓ Durable Powers of Attorney for
Health Care Decisions
✓ Do Not Resuscitate Order (DNR)
✓ Provider Order for Life-Sustaining
Treatment (POLST)
✓ Advance Directive for Psychiatric Care
These documents are filed with the Advance
Directive Registry of the Nevada Lockbox.
The Guardianship Nomination Registry holds
a registrant’s Request to Nominate Guardian
Form. An adult person may use this form to
nominate another person to serve as their
guardian in the event that designation of a
guardian by a court becomes necessary. The
form must be signed by the registrant requesting
the nomination, two impartial adult witnesses and
must be notarized. If a person applies to a court
to be designated as the guardian of a person, the
court must first determine whether a guardian has
already been nominated for the person by
accessing the Nevada Lockbox.
Who has access to the Nevada Lockbox?
Documents stored
within the Nevada
Lockbox are accessible
only by registrants,
anyone to whom the
registrant gives access,
and Authorized Entities.
An Authorized Entity is an organization that has
been given permission to access the registry. The
Advance Directive Registry can be accessed by
Authorized Entities that include, but are not
limited to, providers of health care such as a
hospital, medical practice, hospice care and a
skilled nursing facility. Access to the
Guardianship Registry has been made available
to every District Court in Nevada for use in the
appointment of a guardian. Law enforcement
may also have access in certain circumstances.
Registration with the Nevada Lockbox is
voluntary and at no cost to registrants or
Authorized Entities.
How do I create my advance directive?
Many advance directives or associated
documents may be completed with the assistance
of an attorney or estate planner. A POLST is
prepared by a medical professional for patients
who are seriously ill with a life-limiting illness.
You may also complete some documents
yourself by using online resources. You will find
information on organizations and their resources
by visiting the Forms & Resources section at
www.NevadaLockbox.nv.gov.
What is an Advance Directive Locator?
If you do not want to file documents with the
Nevada Lockbox, complete and file an Advance
Directive Locator Form which provides the
physical location of your documents without
providing the actual content. Note that using the
Advance Directive Locator may delay important
health care decisions until the documents are
located.
Nevada Lockbox
Name: FIRST & LAST NAME
Source: http://www.NevadaLockbox.nv.gov
Registration ID#:
Updated: January 01, 2019
Primary Contact:
Phone:
Alternate Contact:
Phone:
