Wyoming POLST Form: Who It's For, How WyoPOLST Works, and How to Get One

A hospital DNR order does one thing: it tells that hospital's staff what to do during that admission. The moment paramedics show up at your home or you transfer to another facility, it means nothing. Wyoming's answer to that gap is the WyoPOLST — Portable Orders for Life-Sustaining Treatment — a medical order that travels with the patient everywhere, from the ranch house to the ambulance to the ER.

But the WyoPOLST is widely misunderstood. It's not something every adult should sign, it's not a replacement for an advance directive, and it's not valid unless specific rules are followed. Here's what the Wyoming POLST form actually is and how to get one.

Who the WyoPOLST Is For

The WyoPOLST, enacted under W.S. § 35-22-501 et seq. (replacing the old "Comfort One" program on June 30, 2016), is designed for a narrow group: people with a terminal illness and a life expectancy of less than one year, or people living with severe frailty. It translates their treatment preferences into immediate, actionable medical orders.

If you're a healthy 55-year-old doing estate planning, the WyoPOLST is not your document — you need a Wyoming advance directive, which plans for future incapacity. The WyoPOLST is for right now: it's what EMS crews look for when they're standing over a patient who can't speak.

What the Form Covers

The WyoPOLST records decisions about:

• Resuscitation — CPR attempted or do-not-resuscitate.
• Medical interventions — the level of treatment wanted: full treatment, selective/limited treatment, or comfort-focused care.
• Artificially administered nutrition — feeding tubes and IV nutrition.

Whatever is chosen, Wyoming law mandates a floor: providers must always offer comfort measures, pain management, and oral food and water as long as medically feasible. "Comfort-focused" never means "abandoned."

Section E — the incapacitation clause — deserves special attention. It contains an optional line you initial while you still have capacity. If initialed, it locks in the form's instructions: no next of kin or surrogate decision-maker can override them if you later become incapacitated. For families with a history of conflict over end-of-life choices, that one initial is the strongest protection on the page.

Signing and Validity Rules

This is a medical order, not a legal form you fill out alone at the kitchen table. To be valid:

• A licensed Wyoming healthcare professional must complete the form based on your preferences and current medical status.
• It must be signed by both a licensed clinician — a physician, physician assistant, or advanced practice registered nurse (including an FNP) — and you or your legal representative.
• The official form is printed on gold (or yellow) cardstock so first responders recognize it instantly. Photocopies and faxes are legally valid, but the gold original is strongly encouraged.
• It's voluntary. No provider or facility can force you to have one — but many people with serious illness want one precisely because it makes their wishes operational.

There's no charge for the clinical execution. Some patients pair the form with an authorized medical ID bracelet (the StickyJ bracelet runs about $28) so responders know the order exists before they find the paper.

WyoPOLST vs. Advance Directive vs. OOH-DNR

Wyoming has three related documents, and mixing them up is common:

• Advance Health Care Directive — a planning document any competent adult signs. Appoints an agent, records future wishes. Not a medical order; EMS won't act on it.
• WyoPOLST — an active medical order for the seriously ill or severely frail, signed by a clinician, honored across all settings including at home.
• Out-of-Hospital DNR (OOH-DNR) — a narrower emergency order under W.S. § 35-22-201 et seq., signed by patient and attending physician, covering resuscitation only. It's automatically revoked if the patient is pregnant or the death occurs under unnatural or suspicious circumstances. The WyoPOLST has largely absorbed this role for most patients.

If you have a WyoPOLST, keep the gold original somewhere responders will find it — the front of the refrigerator or just inside the front door is the standard Wyoming practice — and make sure your family and your advance directive agent know it exists. If the WyoPOLST and an older directive conflict, talk to the clinician about reconciling them; the most recent, most specific expression of your wishes controls.

How to Get One in Wyoming

1. Bring it up with your doctor, PA, or APRN — they'll confirm whether your condition makes a POLST appropriate.
2. Work through the form together, section by section. Decide on Section E deliberately.
3. Both of you sign. Keep the gold original; give copies to your agent, family, and home-health providers.
4. Review it whenever your condition or your wishes change — a WyoPOLST can be updated or revoked, and outdated orders cause real harm.

The Wyoming Department of Health's Aging Division publishes the official form and a FAQ, and the Wyoming Medical Society maintains provider resources. If you're coordinating a WyoPOLST for a parent while also getting their advance directive, agent designations, and storage plan in order, the Wyoming Advance Directive & Living Will Kit includes a WyoPOLST transition guide that walks through exactly when to move from planning documents to portable medical orders — and how to keep the two consistent.

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