Washington State Department of Social and Health Services Forms

This Form is used for applying to convert a Payment Services Only (PSO) case to a Full Collection Services case in Washington State. This document is available in Amharic.

This Form is used for referring adults for assessment in Washington state.

This Form is used for converting a Payment Only Services (PSO) case to a Full Collection Services case in Washington.

This form is used for converting a Payment Services Only (PSO) case to a Full Collection Services case in Washington state. It is available in Arabic.

This Form is used for applying to convert a Payment Services Only (PSO) case to a Full Collection Services case in Washington. It is available in Russian.

This Form is used for conducting an evaluation of protective agents in the state of Washington. The form is in Spanish.

This document is used for creating an Individual Responsibility Plan for individuals on the Workfirst program in Washington state. It is specifically available in the Cambodian language.

This Form is used for conducting a Protective Payee Assessment in Washington for individuals who speak Trukese.

This document is used in Washington state for creating an individual responsibility plan for participants in the Workfirst program. It is specifically formatted for those who speak Dinka.

This form is used for pre-admission screening and resident review in Washington state. It is required for individuals seeking long-term care services to determine their eligibility and level of care needed.

This form is used for creating an Individual Responsibility Plan for Workfirst program participants in Washington. It is available in Bengali.

This Form is used for creating a Workfirst Individual Responsibility Plan for individuals in Washington who speak Lingala.

This document is a DSHS Form 14-381 Plan de Responsabilidad Individual (IRP) used in Washington state. It is written in Spanish and is used for individual responsibility planning.

This Form is used for creating an Individual Responsibility Plan for individuals participating in the Workfirst program in Washington (Rwanda).

This Form is used for creating a Workfirst Individual Responsibility Plan for Samoan residents in Washington.

This document is for creating an Individual Responsibility Plan for individuals participating in the Workfirst program in Washington. It is available in Somali language to aid Somali-speaking participants.

This Form is used for creating an individual responsibility plan for Workfirst participants in Washington who speak Tagalog.

This Form is used for creating a WorkFirst Individual Responsibility Plan for residents of Washington who speak Nepali. It helps outline goals and responsibilities for individuals participating in the WorkFirst program.

This Form is used for requesting notification of address disclosure in Washington (Cambodian) through the DSHS Form 14-401.

This document is for notifying the Washington State Department of Social and Health Services about the request to disclose an address in Chinese language.

This document is used to notify the Washington State Department of Social and Health Services about a request to disclose your address information.

This document is for creating a Workfirst Individual Responsibility Plan for individuals in the Washington state Workfirst program.

This document is used for notifying the Department of Social and Health Services in Washington about a request to disclose one's address. The form is specifically in Vietnamese.

This form is used to give notice about the request to change address in the state of Washington.

This form is used for creating a Workfirst Individual Responsibility Plan for participants in Washington's Department of Social and Health Services (DSHS) program. It is available in the Thai language.

This form is used for requesting disclosure of address information in Washington state.

This form is used for notification of address disclosure request in Washington (Cambodian).

This document is used for notifying DSHS (Department of Social and Health Services) in Washington about a request to disclose your address. It is in Vietnamese language.

This form is used for notifying the Washington State Department of Social and Health Services (DSHS) about a request to disclose your address information. The form is available in Chinese.

This Form is used for providing notice in Washington State when requesting to change a child's residential address in a custody case.

This Form is used for conducting an eligibility review for long term services and supports in Washington State. It is specifically meant for Italian individuals.

This Form is used for creating an individual responsibility plan for WorkFirst participants in Washington. It is available in Farsi language.