Washington State Department of Health Forms

This document is used for declaring the program director of a medication assistant training program in Washington.

This type of document is used for declaring the program director of a nursing assistant traditional training program in Washington state.

This Form is used for activating an expired psychology credential in Washington state.

This form is used for requesting disability-based accommodation for examinations in Washington state.

This form is used for reactivating the credential of a psychologist who has retired in Washington state.

This form is used for filing a complaint against a transient accommodation in Washington state.

This form is used for activating an expired certification of a radiologic technologist in Washington.

This form is used for applying for certification as a radiologic technologist in the state of Washington.

This Form is used for applying to the Early Intervention Program (EIP) in Washington, which provides insurance premium assistance for eligible individuals.

This form is used for filing complaints or reports in the state of Washington.

This Form is used for making payment for an infant's first newborn screen (NBS) in Washington state.

This form is used for current or returning clients of the Early Intervention Program (EIP) in Washington to confidentially apply for services.

This document is used for obtaining a Certificate of Immunization Status (CIS) in the state of Washington. It is available in both English and Amharic languages.

This form is used for documenting the immunization status of individuals in Washington state. It is available in both English and Spanish.

This Form is used for submitting the Certificate of Immunization Status (CIS) in Washington State. It provides information about the immunization status of an individual.

This Form is used for providing the Certificate of Immunization Status in Washington state. It is available in both English and Punjabi languages.

This type of document is used to certify the immunization status of an individual in the state of Washington. It is available in both English and Ukrainian languages.

This document is used for proving an individual's immunization status in Washington state. It is available in both English and Chinese languages.

This document is for recording and verifying the immunization status of individuals in the state of Washington. It is available in both English and Korean languages.

This form is used for certifying the immunization status in Washington state. It is available in both English and Tagalog languages.

This form is used for obtaining a Certificate of Immunization Status (CIS) in Washington state. It is available in English and Somali languages.

This form is used for documenting the immunization status of individuals in Washington state. It is available in both English and Russian languages.

This form is used for verifying the approval of a supervisor in the state of Washington.

This Form is used for talking to your doctor in Washington state.

This Form is used for requesting employment references in the state of Washington.

This Form is used for requesting an exemption certificate of need for adding psychiatric beds to a hospital in Washington state.

This form is used for notifying the Washington Department of Health of a full facility closure and the transfer of beds to a bed bank in a nursing home.

This form is used for extending the bed banking program in nursing homes in Washington.

This document is for notifying the Washington Department of Health about the modification or alternate use of a bed in a nursing home.

This document is used for notifying the conversion of beds in nursing homes to alternative bed banking in Washington.

This form is used for obtaining a Certificate of Need-Exemption for nursing homes in Washington to renovate or replace beds. It serves as an authorization notice for the bed replacement or renovation.

This document is used for applying for a certificate of need to lease part or all of a hospital in Washington.

This form is used for applying for a Certificate of Need to purchase part or all of a hospital in Washington state.

This Form is used for declaring the completion of statutory requirements for nonorthodontic removable oral devices in Washington.

This form is used for declaring the completion of statutory requirements for teeth whitening services in Washington.

This form is used for midwives in Washington to renew their certification and attest to their continued competence and adherence to professional standards.

This document is used for reactivating an expired midwifery license in Washington state.

This document is for prosthetists in Washington who need to apply for an expired license.