Nevada OD-4 Limited Heart Exam: Police & Fire

Police officers and firefighters in Nevada must undergo periodic physical examinations to qualify for the heart disease presumption under NRS 617.457 and NAC chapter 617. The OD-4 records the limited, interim version of the heart examination: height, weight, blood pressure, whether the person is overweight, a resting EKG and a stethoscopic examination of the heart, each marked normal or abnormal.

Who completes it

The examining physician completes and signs the form, and the officer or firefighter signs as well.

Submitting and payment

How to submit it
The examiner gives a signed copy to the officer or firefighter, who signs and submits one copy to the employer or organization.

Good to know

  • Specify any abnormal EKG or stethoscopic findings; the form lets the examiner recommend that the person consult a personal physician about correcting them.
  • The extensive heart exam (OD-3) adds a stress EKG when indicated, plus lipid and urine glucose results that the OD-4 does not include.
  • Both the examiner and the employee sign, and the employee's signature goes on the copy submitted to the employer or organization.
  • The Division's OD-7 information sheet explains the program and lists the companion OD-1 Medical History and OD-2 lung exam forms.

Get the official form

Download the current version from the source each time; forms change without notice.

Firefighters and Police Officers Limited Heart Examination Form

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

What does the Nevada OD-4 include?

Height, weight, blood pressure, an overweight yes or no, a resting EKG and a stethoscopic examination of the heart, each marked normal or abnormal with specifics. It does not include the stress EKG or the triglyceride, cholesterol and urine glucose results recorded on the extensive OD-3 exam.

Who keeps the signed OD-4?

The examiner signs and gives a copy to the officer or firefighter. The form instructs the employee to sign one copy and submit it to the employer or organization, which documents the exam for the heart disease presumption under NRS 617.457.

What rules govern the Nevada OD exams?

Nevada Administrative Code chapter 617 sets the requirements for police officers and firefighters who must take physical exams to receive benefits under NRS 617.455 and 617.457, including how often exams occur, their minimum content, and the duties of employers and employees, according to the Division's OD-7 information sheet.