Washington State Department of Social and Health Services Forms

This Form is used for making a supported employment referral in Washington State for individuals who speak Mandinka.

This form is used for referral consideration in Washington for enhanced case management services provided by the Department of Social and Health Services (DSHS).

This Formulario is used for reporting and inventorying jobs and training in the state of Washington.

This document is a Vietnamese version of the DSHS Form 11-146 Supported Employment Referral used in Washington. It is used for referring individuals to supported employment programs in Vietnamese language.

This document is used for individuals in Washington state who speak Cambodian and need to sign a consent agreement acknowledging disqualification from certain benefits.

This document is a Russian version of the DSHS Form 11-133 Jobs and Training Inventory used in Washington State. It provides information on job and training opportunities in the state.

This document is a consent agreement form for disqualification in Washington State and is available in Spanish.

This form is used for reporting suspected client fraud in the state of Washington.

This document is for individuals in Washington who speak Somali and need to apply for disaster cash assistance through the DSHS.

This Form is used for supervisors applying to facilitate level 4 domestic violence intervention treatment in Washington.

This Form is used for providing an inventory of jobs and training opportunities offered by the Division of Vocational Rehabilitation in Washington. It is available in Korean.

This Form is used for a Fast Track Service Agreement with the Department of Social and Health Services (DSHS) in Washington state.

This document is the application form used for Russian-speaking individuals in Washington to apply for disaster cash assistance from the Department of Social and Health Services (DSHS).

This form is used for authorizing medical services for juvenile rehabilitation in Washington state.

This Form is used for a Fast Track Service Agreement in Washington for Tagalog speakers.

This document is used for the annual continuation of medication for psychoactive medication treatment plans in Washington state.

This form is used for conducting dementia screening in assisted living facilities (ALFs) in Washington state. It helps assess the cognitive abilities of individuals living in ALFs to determine if they have dementia.

This form is used for referring individuals in Washington to nursing services for home and community-based care.

This document is used for creating a treatment plan involving psychoactive medication in the state of Washington.

This Form is used for the Admissions Review Team Checklist for Admission to an ICF/IID or SONF at a Residential Habilitation Center (RHC) in Washington.

This document is used for the Fast Track Service Agreement in Washington state for Somali speakers.

This Form is used for the review of medical evidence in the state of Washington by the Department of Social and Health Services (DSHS).