Wyoming Board of Registration in Podiatry
To use the forms below, you must download or print them from the File Menu after you open the document.
Podiatrist Application Forms
Initial Licensure Application - For those not currently licensed to practice in another jurisdiction and has never been licensed in Wyoming.
Reciprocity Application - For those currently licensed to practice in another jurisdiction with licensure requirements as stringent as Wyoming, has held that license for at least one (1) year, and can present satisfactory proof of endorsement from that jurisdiction. Satisfactory proof of endorsement shall mean a license in good standing without restriction, condition, or other disciplinary action.
Relicensure Application - For those who have been licensed in Wyoming and failed to timely renew.
Reinstatement Application - For those seeking reinstatement following disciplinary action.
Podiatric Assistant Application Forms
Initial Application - For those seeking their first podiatric assistant permit.
Transfer Application - For those transferring their permit to another podiatrist.
Other Forms
Address / Name Change Form - To request a change in your name or contact information.
Replacement Documents Form - To request replacement license materials.
Verification Request Form - To have your Wyoming license verified to another jurisdiction .
Inquiries regarding these application procedures and application status may be directed to Carlos Gomez at (307) 777-3628 or carlos.gomez@wyo.gov.