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UPC Submission

Downloadable UPC Submission Forms:

Complete all sections of this form to submit a new product for review:

  1. Include a copy of the product label showing the product name, size and ingredient list. Multiple pictures can be submitted. 
  2. Include a copy of the product UPC barcode with all 12 digits listed.
  3. Fax or email this completed form, product pictures, and barcode to:

Fax: 775-684-4246   

E-mail: DPBHWICVendor@health.nv.gov

If you have any questions, please contact the Vendor Coordinator Marisa Cook at 775-400-0624 or DPBHWICVendor@health.nv.gov. 

  • Contact Information

    We need to be able to contact you if there are questions on the product submitted.
  • Product Information

  • Weight and/or Volume
  • MUST INCLUDE ALL 12 DIGITS
  • Please provide the full product label to include: front panel, nutrition fact section, and ingredients. Up to five pictures can be submitted (20MB each maximum).
    Drop files here or
    Accepted file types: pdf, jpg, gif, png, Max. file size: 20 MB, Max. files: 5.