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Healthcare Facility Licensure: Annual Renewal

 2015-2016 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 and mailed, as original signatures are required.
  • We cannot accept an electronic application submission.
    If you have more than one facility, a separate check and 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 15, 2015.

If your facility plans on terminating services effective June 30, 2015, or prior,
you must notify this office, in writing, in advance, with your termination date.

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


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 us of a change in facility ownership,
click here for more information.