Washington State Department of Social and Health Services Forms

This form is used for reviewing eligibility for long term services and supports in Washington state. It is specifically translated into Polish.

This form is used for conducting an eligibility review for long-term services and supports in Washington state. It is available in Vietnamese.

This type of document, DSHS Form 14-416, is used for reviewing eligibility for long term services and support in Washington state. It is available in Somali language.

This document is used to notify individuals in Washington who are awaiting approval to provide in-home care as family, friends, or neighbors.

This form is used for applying for the Community First Choice (CFC) or Medically Needy (MN) programs under the Washington state Department of Social and Health Services (DSHS). It allows individuals to apply for long-term care services and support through the Community Options Program Entry System (COPES).

This document is used for notifying the Department of Social and Health Services in Washington of a change in Family, Friend or Neighbor (FFN) provider.

This form is used for changing the provider for the Family, Friend, or Neighbor (FFN) program in Washington state, specifically for Cambodian language users.

This document is a pending letter in Tagalog for the DSHS Family, Friend and Neighbor (FFN) In-Home/Relative program in Washington. It is used to communicate the status of an application or assessment for FFN childcare services to individuals who speak Tagalog.

This document is used for authorizing medical/dental services in Washington State. It is provided in Somali language.

This form is used for authorizing medical and dental services in Washington state. It is specifically available in the Lao language.

This document allows Vietnamese-speaking individuals in Washington to access the Protective Payee Payment Plan, Case Assignment, and Closure Notice. It helps ensure the proper and secure management of financial payments and provides closure details for specific cases.

This Form is used for enrolling in direct deposit for cash assistance in the state of Washington.

This Form is used for enrolling in direct deposit for financial assistance in Washington State.

This Form is used for reporting work stoppage to the Washington State Department of Social and Health Services (DSHS) for individuals who speak Lao.

This form is used to report a stop work situation to the Washington State Department of Social and Health Services. It is available in Somali language.

This Form is used for employee termination in Washington state.

This Form is used for requesting a stop work order in Washington state for Trukese speakers.

This Form is used for reporting a stop work situation in the state of Washington. It is available in Russian.

This type of document is a form used by the Washington State Department of Social and Health Services (DSHS) to stop work in Mongolian language.

This document is for making a protective payee decision in Washington state. It is available in Vietnamese.

This document is for making a decision about a protective payee for Washington residents who speak Trukese.

This type of document is an authorization form for medical and dental services in Washington. It is used by the Department of Social and Health Services (DSHS).

This form is used for making a protective payee decision in the state of Washington. It is available in the Somali language.

This form is used to collect information needed by the Department of Social and Health Services (DSHS) in the state of Washington.

This form is used for collecting information from individuals residing in Washington who speak Somali. The purpose of this document is to gather specific information for the relevant authorities.

This type of document is a form used by the Department of Social and Health Services in Washington state to gather necessary information.

This form is used for requesting verification of epilepsy from the Washington State Department of Health and Social Services.

This Form is used for providing necessary information to the Department of Social and Health Services (DSHS) in Washington state.

This form is used for gathering information needed by the Washington Department of Social and Health Services (DSHS). It is available in Vietnamese.

This form is used for recording transportation waiver request information for individuals with developmental disabilities in Washington state.

This form is used to request information from the Washington State Department of Social and Health Services (DSHS). The form is available in Tagalog for individuals who prefer to communicate in that language.