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Wyoming Forms

Find and complete the correct forms
for your local health center.

The following forms are for use at clinic locations in Wyoming —
Cody, Greybull, Lovell, Powell and Sheridan.

DOWNLOAD PATIENT INFORMATION/FORMS

Big Sky Care Connect

New Patient Intake Form

Release of Protected Health Information

imMTrax Consent Form

Big Sky Care Connect Opt Out

Notice of Privacy Practices

Sliding Fee Discount Program Application

Consumer Bill of Rights

Sliding Fee Discount Program Information

Patient Information/Forms

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