048-1 Wyo. Code R. § 1-4

Current through April 27, 2019

Section 1-4 - Submission of an Evaluation Record

(a) The neurologist who signs the certification shall provide a copy of the evaluation and observation record of the patient to the department within five business days after signing a written certification.

(b) The evaluation record must include the following:

• (i) The qualifying patient's name and date of birth;

• (ii) Date of clinic office visit;

• (iii) The neurologist's name, professional license number and expiration date;

• (iv) A diagnosis of intractable epilepsy; and

• (v) If the record is submitted for a registration card renewal, the patient's response to hemp extract as to effect on seizure control and adverse effects attributable.

048-1 Wyo. Code R. § 1-4

Adopted, Eff. 10/16/2015.