Health Alert Network Enrollment Form

The "blastfax" system is used to send out critical information to health care professionals quickly. The system allows us to transmit timely information to you — the health care providers in Southern Nevada — promptly and efficiently via fax lines or email. We invite you to join our distribution list by filling out the below form.

* Indicates a required field
* Requestor's Name
* Fax Number
* Office Phone
* Email Address
Business/Facility Name
Business Mailing Address
City	State	Zip
* How do you prefer to receive alerts? Fax Email Fax & Email
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If you have any questions, please call the Health Alert Network Coordinator at (702) 759-1385.