Washington State Department of Social and Health Services Forms

This Form is used for requesting travel time reimbursement for individual providers in Washington State.

This Form is used for the Affidavit of Forged Endorsement in Washington specifically for cases involving Cambodian individuals.

This document is used for reporting self-employment income in the state of Washington. It is necessary for individuals who are self-employed to accurately report their income for tax and benefit purposes.

This document is used for goal setting and action planning in Washington state. It is a worksheet provided by the Department of Social and Health Services (DSHS) to help individuals set goals and create a plan of action to achieve them.

This form is used for reporting a forged endorsement in Washington state.

This form is used for self-employed individuals in Washington to track their monthly sales and expenses. It helps them to easily calculate their profits or losses for tax purposes.

This Form is used for the Pre-placement Agreement of individuals with developmental disabilities in Washington state.

This Form is used for requesting a conference board through the Washington Department of Social and Health Services (DSHS) for Trukese-speaking individuals.

This Form is used for submitting an Affidavit of Forged Endorsement in Washington state (Lao language version available).

This Form is used for the Alzheimer's Sentence/Copy Design Folstein MMSE assessment, which is conducted by the Home and Community Services department in Washington state.

This Form is used for filing an Affidavit of Forged Endorsement in the state of Washington. It is available in both English and Russian languages.

This form is used for consumer response related to the Office of Deaf and Hard of Hearing in Washington state. It allows individuals who are deaf or hard of hearing to provide feedback or raise concerns about services they have received.

This Form is used for filing an affidavit of forged endorsement in Washington for individuals who speak Somali.

This is a form used by the Washington Department of Social and Health Services (DSHS) for reporting a forged endorsement. It is available in both English and Spanish.

This Form is used for submitting an Affidavit of Forged Endorsement for cases in Washington. It is available in Vietnamese.

This Form is used for filing a Petition for Modification of an Administrative Order in the state of Washington.

This type of document is used to submit a petition for modification of an administrative order in the state of Washington. It is available in Amharic.

This Form is used for filing a petition to modify an administrative order in Washington State, specifically for individuals who speak Armenian.

This document is for filing a petition to modify an administrative order in Washington state. It is available in Burmese language.

This Form is used for filing a Petition for Modification of an administrative order in Washington State specifically for Marshallese individuals.

This form is used for referring individuals to the Washington Department of Social and Health Services (DSHS) for the Basic Food Employment and Training (BFET) program.

This form is used for reporting credit balances in nursing homes in Washington.

This document is for reporting credit balances in nursing homes in Washington state.

This form is used for reporting a protective payee in Washington State. It is used to provide information on the payee's finances and ensure they are properly managing funds on behalf of another individual.

This form is used for requesting an exception to a rule within the Washington State Department of Social and Health Services (DSHS).

This form is used for the Limitation Extension Evaluation in Washington state for the Department of Social and Health Services (DSHS).

This form is used for requesting a hearing in the state of Washington through the Department of Social and Health Services (DSHS).

This form is used for clients under the age of 21 in Washington to request an extension on certain limitations.

This document is an application form for individuals in Washington seeking an internship with the Division of Vocational Rehabilitation (DVR). It is used to apply for an internship opportunity with the DVR program.

This Form is used for filing a petition to modify an administrative order in Washington state, specifically for individuals who speak Sudanese Arabic.

This Form is used for individuals participating in a vocational rehabilitation internship program in Washington state. The form outlines the agreement between the intern and the Division of Vocational Rehabilitation.

This form is used for filing a consumer complaint in the state of Washington.

This Form is used for requesting a hearing in Washington, specifically for individuals who speak Arabic.

This document is used for keeping track of attendance and generating billing invoices for services provided in the state of Washington.