The Wyoming Advance Directive creates a legally binding arrangement for decisions to be made in regard to an individual’s health care should they become incapacitated. The paperwork covers a range of options to prepare for the purpose of indicating the desired treatment options in the event that a patient is in a position where they can no longer speak for themself. The form provides space to establish an agent to speak on their behalf and make any determinations for care not specified in the document. State law requires either a professional notary to oversee the endorsement of the contract, or at least two (2) witnesses to appropriately validate the commitments therein.
Laws
Statute – Wyoming Health Care Decisions Act
Definition – “Advance health care directive” means an individual instruction or a power of attorney for health care, or both (§ 35-22-402)
Signing Requirements – Authorization of the execution of the document is required to be carried out by a licensed notary official or at least two (2) eligible witnesses as indicated by Wyoming Statute § 35-22-403.
Other Versions (6)
- AARP (Caring Connections)
- Campbell County Health
- Cheyenne Regional Health Medical Center
- Five Wishes (Aging with Dignity)
- Prepare for Your Care
- Wyoming Medical Center
AARP (Caring Connections) Version
Download: Adobe PDF
Instructions: Adobe PDF
Campbell County Health Version
Download: Adobe PDF
Cheyenne Regional Health Medical Center Version
Download: Adobe PDF
Information: Adobe PDF
Five Wishes (Aging with Dignity) Version
Download: Adobe PDF
Information: Adobe PDF
Prepare for Your Care Version (also available in Spanish/en Español)
Download: Adobe PDF
Wyoming Medical Center Version
Download: Adobe PDF
Information: Adobe PDF
Additional Resources
- Compassion & Choices – My End of Life Decisions Guide
- Compassion & Choices – COVID-19 Advance Care Planning
- University of Wyoming – Advanced Health Care Directive Pamphlet
- Wyoming Medical Center – Advance Planning Guide for Health Care and End-of-Life Decisions
Related Forms (5)
- Advance Directive Wallet Card
- Durable (Financial) Power of Attorney Form
- Psychiatric Advance Directive Form
- Wyoming WyoPOLST Providers Orders for Life-Sustaining Treatment Form
- Wyoming Department of Health Authorization to Release Health Records
Download: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF, MS Word (.docx)
Psychiatric Advance Directive Form
Download: Adobe PDF
Information: Adobe PDF
Wyoming WyoPOLST Providers Orders for Life-Sustaining Treatment Form (WY HB-0162)
Download: Adobe PDF
Wyoming Department of Health Authorization to Release Health Records
Download: Adobe PDF