Wyoming Department of Health Forms

This document is an application for health coverage and financial assistance for individuals residing in Wyoming. It helps residents access affordable health insurance options and determine if they are eligible for financial support to help cover the costs.

This type of document is a "Solicitud Para Cobertura De Salud & Ayuda Para Pagar Costos" which is used in Wyoming. It is a form used to apply for health coverage and assistance in paying for costs.

This document is a questionnaire used in Wyoming to assess the risk of a patient for tuberculosis (TB) infection. It helps healthcare providers determine the likelihood of a patient having TB and guides them in appropriate treatment and control measures.

This Form is used for filing complaints regarding the Office of Emergency Medical Services in Wyoming.

This form is used for exchanging compact information related to EMS (Emergency Medical Services) in Wyoming. It helps facilitate communication and coordination between different EMS agencies and entities.

This form is used for applying for a temporary emergency license in Wyoming.

This document is used for inspecting air medical aircraft in Wyoming. It ensures that the aircraft meet the necessary safety and operational standards for providing emergency medical services.

This Form is used for reporting adoptions in the state of Wyoming.

This Form is used for Authorization to Access Medical History in Wyoming.

This Form is used for authorizing the release of health records in Wyoming.

This document provides information about the Emergency Medical Services (EMS) Needs Assessment Grant in Wyoming. It outlines the process and requirements for applying for the grant and determining the needs of the EMS system in the state.

This document is for applying for an emergency medical services needs assessment grant in Wyoming.

This form is used for healthcare providers in Wyoming who want to apply to participate in the Volunteer Health Services Program.

This document provides important information regarding eligibility and required disclosures for the Volunteer Health Services Program in Wyoming. Learn about the program's requirements and how to apply as a volunteer.

This Form is used for applying to be an agent in the Child & Adult Abuse/Neglect Central Registry Screen in Wyoming.

This form is used for authorized providers in Wyoming to submit background information for a background check.

This document is for self-directed care providers in Wyoming to submit background information. It coversheet for the self-directed care background submission.

This document is used for justifying the order volume in Wyoming. It helps to provide reasons for the quantity of items or goods that need to be ordered.

This document is used for acknowledging the Acip recommendations and vaccine storage for the Yellow Fever Vaccine Program in Wyoming.

This document outlines the emergency plan for relocating vaccines in the state of Wyoming. It provides guidelines and procedures in case of unforeseen events that may require vaccine relocation.

This Form is used for specifying use and disclosure restrictions in the state of Wyoming.

This form is used for requesting an amendment to a document in the state of Wyoming. It allows individuals or businesses to make changes to previously filed paperwork.

This form is used for healthcare providers to withdraw from the Wyoming Public Vaccine Program in Wyoming.

This form is used for reporting fraud and abuse in the Wyoming Women, Infants, and Children (WIC) program in Wyoming.

This document is used for collecting comments and feedback from participants of the Wyoming WIC Program who shop at a grocery store.

This Form is used for gathering comments from patients or clients of Clinic/WIC Staff in Wyoming.

This document is for participants in the Wyoming WIC program who want to provide feedback to the supermarket. It is a form where they can leave comments.

This document is used for enrolling children in Wyoming schools and child caring facilities under certain conditions. It ensures that children meet the necessary requirements for enrollment in these educational and childcare institutions.

This form is used for requesting a medical waiver in the state of Wyoming. It is applicable for individuals who need an exemption from certain medical requirements for specific purposes.

This form is used for requesting a religious waiver in the state of Wyoming. It allows individuals to seek an exemption from certain legal requirements based on their religious beliefs.

This Form is used for requesting religious exemption in Wyoming. (Spanish)

This form is used for vaccine coordinators in Wyoming to acknowledge and comply with the recommendations and storage requirements for the Yellow Fever Vaccine Program.

This document outlines the process of maintaining the integrity and traceability of microbiology samples in Wyoming. It provides guidelines for proper handling and documentation to ensure accurate and reliable test results.