• Goldfield Court House
  • Lyon County Court House
  • Pershing District Court
  • Lincoln County Court House
  • Humboldt County Court House
  • Eureka District Court
  • Eureka Justice Court
  • Alamo Justice Court
  • Elko County Court House
  • Las Vegas Regional Justice Center

Protection Orders Overview

Domestic Violence Protection Order Forms

The following are Supreme Court approved standardized forms for mandatory, or voluntary, use in the issuance of temporary and extended protection orders against domestic violence.  The Court approved the forms in an ADKT 269 dated December 5, 2008.

The application and forms are provided in fillable Adobe PDF format and as regular PDF files as well.

The Court Order forms are not available on this website in the fillable file format, but are available to Courts by contacting John McCormick at AOC directly.  The native MS Word versions of the documents are also available to Courts.


Application (PDF or Fillable)
Temporary Protection Order
Extended Protection Order
Confidential Information Sheet (PDF or Fillable)
Return of Service (PDF or Fillable)


Protection Order Handbook
Application Instructions
Motion and Affidavit (PDF or Fillable)
Notice of Hearing (PDF or Fillable)
Order to Modify, Dissolve, or Extend

*All Domestic Violence Protection Order Forms, including forms in additional languages can be found here.

Domestic Violence Passport Coversheets

The following are Passport Coversheets, which contain all the information necessary for law enforcement to enforce the order and also make the order more enforceable across jurisdictions.  Use of these Coversheets is voluntary, but the use of these Coversheets is a growing national trend.

Passport Coversheet - Temporary

Passport Coversheet - Extended

Stalking and Harassment/Harassment in the Workplace Protection Order Forms

The Standardized Forms for Mandatory Use in Stalking and Harassment, Workplace Harassment and Harm to Minors can be found here

Sexual Assault Protection Order Forms


Application for Protection Order - Sexual Assault
Temporary Protection Order
Extended Protection Order


Application Instructions
Return of Service
Return of Service (Domestic Violence)
Motion Form
Confidential Information Sheet (Court)
Confidential Information (Law Enforcement)


Protection Order Handbook
Notice of Hearing
Order of Hearing
Order - Modification
Order - Dissolved
Continuation Page
Confidential Information Sheet - Court information and Law Enforcement (combined)
Denial of Order
Passport Page - Temporary Order
Passport Page - Extended Order

Protection Order Forms Committee History

In October 2007 the Judicial Council of the State of Nevada (JCSN) approved the formation of an interim statewide Protection Order Forms Committee (Committee) under the auspices of the JCSN to consider how any new enacted legislation would affect the standardized protection order forms, and to make any necessary changes to the forms. In addition, the Committee may examine various policy issues regarding the forms and make recommendations to the JCSN for submission to the Supreme Court. The Committee examines all standardized protection forms, which includes domestic violence, stalking, aggravated stalking, harassment, workplace violence, harm to minors, and sexual assault.

The 2007 legislature enacted legislation that made a number of technical and substantive changes that affected the standardized Protection Order forms. In particular, AB Bill 194 and AB 282 contained language that involved substantive changes to the domestic violence standardized forms that needed to be reviewed by the Committee. The below Protection Order forms for domestic violence were designated as mandatory or voluntary, and were approved by an Order of the Supreme Court in December of 2008.

In 2009-2010, the Committee’s primary focus was to review Assembly Bills 120 and 309, and create standardized protection order forms for victims of sexual assault requesting a protection order, as well as review the stalking and harassment protection orders to address the new definitions of stalking and harassment in Assembly Bill 309.

The Nevada Legislature did not make any changes to protection order statutes in 2011. The Committee may be reconvened in the future provided that changes to the forms become necessary.


John McCormick
Assistant Court Administrator
Administrative Office of the Courts
201 South Carson St., Suite 250
Carson City, Nevada 89701
Telephone: (775) 687-9813
Fax: (775) 687-9811
Email: jmccormick@nvcourts.nv.gov