Forms

How do you apply?  
Due to current public health concerns, all Clark County Social Service offices are temporarily closed to the public. Applications may be submitted online at ccssreferrals@clarkcountynv.gov or by fax at 702-678-5221.

Notice of Privacy Practices

CCSS Application - English
Applications can be emailed to CCSSReferrals@ClarkCountyNV.gov, faxed to 702-678-5221 or mailed to CCSS 1600 Pinto Lane Las Vegas, NV 89106.

CCSS Application - Spanish     
Las solicitudes pueden enviarse por correo electrónico a CCSSReferrals@ClarkCountyNV.gov, por fax al 702-678-5221o enviarse por correo a CCSS 1600 Pinto Lane Las Vegas, NV 89106.

Long Term Care application

HHHA Referral

W9 to be filled out by Property Owner Please click here