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.
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.
• Adult Day Care Facility
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 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