Wyoming Department of Health Forms

This document is a requisition for Enterovirus Testing in Wyoming. It is used to request laboratory testing for the presence of Enterovirus in individuals residing in Wyoming.

This Form is used for requesting influenza testing in the state of Wyoming.

This document is used to request patient test results to be sent by fax in Wyoming.

This document is used for collecting additional information and conducting nucleic acid amplification testing for tuberculosis in the state of Wyoming.

This form is used for new water customers in Wyoming.

This document contains the results of a price survey conducted for the Wyoming WIC program in Wyoming. It provides information on the prices of various food items and products in the area.

This document is used to request electronic funds transfer (EFT) for participants of the Wyoming WIC Program in Wyoming.

This document is used for requesting the addition or change of a Universal Product Code (UPC) in the Wyoming WIC Program.

This document is used for vendors participating in the Wyoming WIC Program to submit their comments and feedback.

This document is a confidential disease report specific to the state of Wyoming. It contains information related to the diagnosis and reporting of certain diseases in Wyoming.

This document is a checklist for rehab facilities in Wyoming to obtain state licensure. It ensures that the facility meets all the necessary requirements and regulations.

This document provides a checklist for state licensure for rehabilitation hospitals in Wyoming. It includes the requirements and criteria that must be met for obtaining a license to operate a rehabilitation hospital in the state.

This document provides a checklist for licensing a boarding home in the state of Wyoming. It includes the requirements and guidelines that must be met to obtain a license.

Hospice Multiple Locations in Wyoming provides end-of-life care and support services to patients with life-limiting illnesses.

This checklist is used for obtaining state licensure for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) in Wyoming. It outlines the requirements and guidelines that must be met to obtain the necessary license.

This form is used for reporting crucial data from rural health clinics in Wyoming.

This document outlines the paperwork requirements for obtaining a state license for hospitals in Wyoming. It provides information on the necessary documents and forms that hospitals need to submit in order to comply with state regulations.

This form is used for submitting complaints regarding healthcare facilities in Wyoming.

This document outlines the paperwork requirements that a Critical Access Hospital in Wyoming must fulfill in order to obtain state licensure. It provides information on what forms and documents need to be submitted as part of the licensure application process.

This Form is used for submitting complaints related to the Wyoming Office of Emergency Medical Services.

This document is a temperature log for a refrigerator in Wyoming. It is used to track the Celsius temperature inside the refrigerator over time.

This document is used for logging the temperature in a freezer in Wyoming, using Celsius.

This document is a temperature log specifically designed for an ultra cold freezer in Wyoming. It uses Celsius as the unit of measurement. The log is used to keep records of the freezer's temperature to ensure that it remains at the desired level for storing temperature-sensitive items.

This Form is used for ordering supplies for WPHL in Wyoming.

This form is used for reporting animal bites and possible cases of rabies in Wyoming. It helps authorities track and respond to potential public health concerns.

This document is used for applying for vendor authorization with the Wyoming WIC Program in Wyoming.

This form is used for verifying the identity and submission details of individuals submitting documents in Wyoming.

This form is used for the functional screening of individuals residing in assisted living facilities in Wyoming. It helps assess the physical and cognitive abilities of residents.

This Form is used for conducting a functional screening for Assisted Living Facilities in Wyoming. It provides instructions on how to properly assess the functional abilities of residents in these facilities.

This document is used for reporting cases of sexually transmitted diseases (STDs), HIV, and viral hepatitis in the state of Wyoming. It helps to track and monitor the prevalence of these diseases in the state.

This form is used for requesting a waiver of state licensure rules in Wyoming. It is used when an individual or entity needs an exemption from certain licensing requirements in order to perform a specific activity or operate a business.

This document is a checklist used to ensure that a hospice facility in Wyoming meets the requirements for state licensure. It outlines the criteria and standards that must be met in order to obtain and maintain a license for operating a hospice facility in Wyoming.

This document is a sample contract for healthcare facilities in Wyoming to engage third-party services.

This document is used for applying for the reinvestment of Civil Money Penalty (CMP) in Wyoming.

This Form is used for requesting communicable disease data in Wyoming. It helps government agencies and researchers gather information related to the spread and control of diseases in the state.