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Healthcare Facility Licensure: Annual Renewal


 

** 2014-2015 LICENSE APPLICATION RENEWAL **

 

Click on the appropriate facility type at the bottom of this page to access the license renewal application.

 

The application may be completed electronically; however, it must be printed, as original signatures are required.  We cannot accept an electronic application submission.

 

  • If you have more than one facility, a separate check and a separate application must be submitted for each facility.  
  • Credit card payments are not accepted.
  • Payment should be made payable to TREASURER, STATE OF WYOMING.
  • Please send the original signed application and fee to the address listed at the top of the application.

SUBMISSION DEADLINE

Original application and fee must be received no later than May 09, 2014.

 

If your facility plans on terminating services effective June 30, 2014, or prior,

you must notify this office in writing, in advance, with your termination date.


Please note: license applications are provided in MS Word format.  If you experience problems opening the license application, or wish to request the application be e-mailed to you in PDF format, please contact us by e-mail or by telephone: (307) 777-7123.
 

Adult Day Care Facility
Adult Foster Care Home
Ambulatory Surgical Center
Assisted Living Facility

Birthing Center

Boarding Home Facility
Critical Access Hospital

End Stage Renal Dialysis Center

Free-Standing Diagnostic Testing Center

Home Health Agency

      Home Health Agency - Sub-Unit
Hospice Program

Hospital

Intermediate Care Facility for the Mentally Retarded
Medical Assistance Facility

Nursing Care Facility (Nursing Home)
Psychiatric Hospital
Rehabilitation Facility
Rehabilitation Hospital



New healthcare facility?
Change in ownership of a currently-licensed facility?

If you are licensing a new healthcare facility, or
need to notify this office of a change in facility ownership,
click here for more information.