DSHS Form 10-489 Confidential Health Information Consent Agreement or Withdrawal - Washington

What Is DSHS Form 10-489?

This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

• Released on March 1, 2022;
• The latest edition provided by the Washington State Department of Social and Health Services;
• Easy to use and ready to print;
• Available in Somali;
• Quick to customize;
• Compatible with most PDF-viewing applications;
• Fill out the form in our online filing application.

Download a printable version of DSHS Form 10-489 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.