Skip Navigation Links Wyoming Department of Health

IMPORTANT NOTICE: Many pages on this site may not display properly for Internet Explorer 11 users. Please consider another browser such as Chrome or Firefox.

Forms

      Assisted Living Facility
           ALF 102:  Word   PDF Format 
           ALF 102 Manual:  Word   PDF Format
           ALF Manager Test:   Word   PDF Format
           ALF Procedure 024 - Level 2 Assisted Living Facility Managers:  PDF Format

      Certified Nurse Aides

      Facility Change in Administrator, Director, Director of Nursing, or E-Mail Address
           Word    PDF Format

      CLIA Application for Certification

      Complaints against Healthcare Facilities

      Construction of Healthcare Facilities

      Incident Report by healthcare facility-excluding Fire/Explosion/Life Safety Code Incidents/Accidents

      Incident Report by healthcare facility-Fire/Explosion/Life Safety Code-Incident/Accident
           Word    PDF Format

      Reported Diseases and Conditions