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WyoPOLST - Wyoming Department of Health

WyoPOLST - Wyoming Department of Health 2026

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The WyoPOLST document outlines the Providers Orders for Life Sustaining Treatment in Wyoming, detailing patient preferences for medical interventions based on their current health status. It includes sections for cardiopulmonary resuscitation (CPR) choices, medical interventions, and artificially administered nutrition. The form emphasizes the importance of respecting patient dignity and wishes, requires signatures from healthcare providers and patients or their representatives, and encourages regular reviews and updates to ensure alignment with the patient's evolving health condition and treatment goals.

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Click ‘Get Form’ to open the WyoPOLST document in the editor.
Begin by entering the patient's Last, First, and Middle Name at the top of the form. If applicable, place the ID sticker here.
Fill in the Date of Birth and Last 4 digits of the Social Security Number. Select the Gender by checking either 'M' or 'F'.
In Section A, choose between 'CPR / Attempt Resuscitation' or 'DNR / Do Not Attempt Resuscitation'. This indicates how to respond in case of cardiac arrest.
Move to Section B and select one option regarding Medical Interventions: 'FULL TREATMENT', 'SELECTIVE TREATMENT', or 'COMFORT-FOCUSED THERAPY'. Each option outlines different levels of care.
Complete Section C for Artificially Administered Nutrition by selecting one of the options provided.
In Additional Orders, specify any other medical interventions desired by writing them in the space provided.
Ensure that both the Primary Health Care Provider and Patient (or Legal Representative) sign and date at the bottom to validate the form.

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Is it hard to get Medicaid in Wyoming?

Apply for Medicaid in Wyoming Eligibility: Pregnant women and children are eligible with household incomes up to 154% of poverty (children are eligible for CHIP with household incomes up to 200% of poverty). Parents with dependent children are eligible with household incomes up to 56% of poverty.

How to get a DNR in Wyoming?

Ensure that your DNR order includes all necessary details such as your full name, date of birth, and clear directives regarding resuscitation. It must be signed and dated by both you (or your legal representative) and your physician, and it may require notarization or witnesses as per state law. Wyoming Do Not Resuscitate (DNR) Form - BoloForms Do Not Resuscitate | Comprehensive Guide Template contracts personal-family Do Not Resuscitate | Comprehensive Guide Template contracts personal-family

Where to apply for Wyoming Medicaid?

Apply online at: .wesystem.wyo.gov or apply over the phone by contacting the Wyoming Department of Health Customer Service Center at 855-294-2127. Pregnant women may also apply for the Presumptive Eligibility Program through a Qualified Provider. What is Medicaid? - Wyoming Department of Health Wyoming Department of Health healthcarefin medicaid Wyoming Department of Health healthcarefin medicaid