Washington State Department of Social and Health Services Forms

This document is used for disability review in Washington. It is available in the Tagalog language.

This Form is used for conducting a disability review in the state of Washington. The form is available in Vietnamese language for convenience.

This form is used for disability review in Washington state. It is specifically for individuals who speak Russian.

This form is used for the disability review process in the state of Washington. It is available in the Somali language.

This Form is used for designating an authorized representative in Washington State.

This document is for individuals in Washington who need to appoint an authorized representative for DSHS services.

This form is used for appointing an authorized representative in Washington State for individuals who speak Trukese language.

This Form is used for designating an Authorized Representative in Washington State for non-English speakers who speak Punjabi.

This form is used for appointing an authorized representative for DSHS services in Washington. The form is available in Farsi language.

This Form is used for reporting medical information for ABWD requirements in Washington state.

This Form is used for conducting quality improvement visits and assessments of Adult Family Homes (AFHs) in the state of Washington. It helps the Department of Social and Health Services (DSHS) in ensuring the quality and safety of care provided to residents in AFHs.

This form is used for applying for registration with the Community Residential Care Centers (CCRCs) in Washington state.

This document is for the denial notice in the Washington State Combined Fund Drive (CFD) Charitable Contribution Program. It is written in the Lingala language.

This form is used to schedule appointments for available assistance programs provided by the Washington State Department of Social and Health Services (DSHS).

This form is used in Washington to request enrollment or change from one DDA HCBS waiver to another. It is also available in Somali language.

This document is a denial notice for the Washington State Community First Choice Personal Care (CCSP) program, written in Somali language. It notifies the recipient that their application has been denied for the program.

This document is used for Person Centered Service Planning and Annual Assessment Meeting in Washington State, specifically for the Lao-speaking population.

This form is used for conducting a survey during a person-centered service plan meeting in Washington state. The survey is designed to gather feedback and input from individuals with Lao heritage.

This Form is used for notifying individuals in Washington about an exception to a rule decision made by the Department of Social and Health Services.

This type of document is a notification of the exception decision in Washington, provided by the Department of Social and Health Services (DSHS). It is written in Spanish.

This form is used for notifying individuals in Washington who are affected by an exception to a rule decision made by the Department of Social and Health Services (DSHS). It is available in Somali language.

This Form is used for the DDA Community Protection Program in Washington. It is an agreement which outlines the responsibilities and expectations of a chaperone participating in the program.

This form is used for residents of Washington to notify the Department of Social and Health Services of a change of address.

This form is used for conducting quarterly reviews of community protection treatment in Washington state.