Washington State Department of Social and Health Services Forms

This document provides information on your rights and responsibilities when receiving services from the Aging and Long-Term Support Administration and Developmental Disabilities Administration in Washington. It is available in Nepali language.

This document provides information and guidance on your rights and responsibilities when receiving services from the Aging and Long-Term Support Administration and Developmental Disabilities Administration in Washington State. It is available in Thai language.

This form is used for Individual Providers in Washington State to receive a Stop Work Notice. It is specifically available in the Somali language.

This form is used by the Washington Department of Social and Health Services (DSHS) to provide a memo to a provider for behavior support, counseling, and consultation services. It serves as a communication tool between DSHS and the provider regarding the services needed for a particular individual.

This Form is used for people in Washington who need to ask the Department of Social and Health Services (DSHS) questions. It is available in Cambodian language.

This form is used for keeping track of cash transactions for clients receiving companion home services in Washington through the Department of Social and Health Services (DSHS).

This Form is used for setting up automatic payment authorization in Washington (Georgian).

This Form is used for setting up automatic payment authorization for DSHS in Washington state.

This Form is used for scheduling fingerprint appointments with the Department of Social and Health Services (DSHS) in Washington state for individuals who speak Lao.

This form is used for notifying individuals in Washington about exceptions to rules concerning Adult Family Homes (AFHs). It is available in Somali language.

This form is used for notifying individuals about exceptions to the rules of the CA Medicaid Transformation Demonstration program in Washington. It specifically addresses the Cambodian community.

This form is used for notifying individuals in Washington who are on Medicaid about exceptions to certain rules in the Medicaid Transformation Demonstration.

This form is used for notifying individuals in Washington about exceptions to the rules of the Medicaid Transformation Demonstration. It is available in Korean.

This document is for Somali-speaking residents in Washington who are enrolled in the Medicaid Transformation Demonstration. It provides information about exceptions to certain rules and serves as a notice of action.

This form is used in Washington state for notifying individuals about exceptions to the rules for Adult Family Home (AFH) daily rates. It specifically pertains to Chinese language speakers.

This form is used for notifying individuals in Washington, particularly Cambodians, about exceptions to the rules regarding adult family home (AFH) daily rates.

This type of document is used for providing a notice of action exception to a rule in Washington's Medicaid Transformation Demonstration for Russian speakers.

This form is used in Washington state to notify individuals of exceptions to the daily rates for Adult Family Home (AFH) services. The form is available in Korean.

This document is a notice of action exception to a rule for Adult Family Homes (AFH) in Washington state, but it is in Russian.

This form is used for notifying individuals in Washington who are operating Adult Family Homes (AFHs) about exceptions to the daily rates rule. The form is available in Somali.

This form is used to notify individuals in Washington about an exception to the rules for Adult Family Home (AFH) daily rates. The form is available in Vietnamese.

This form is used for requesting reimbursement for medical evidence in the state of Washington.

This Form is used to report nursing services activity for AAAs (Area Agencies on Aging) in Washington state.

This form is used for conducting customer experience surveys related to public records in Washington state.

This form is used for reporting self-employment income in Washington state. It is specifically designed for individuals who are of Mongolian nationality.

This form is used for reporting self-employment income in Washington for individuals of Cambodian descent.

This form is used for reporting self-employment income for residents of Washington who speak Russian.

This document is used for reporting self-employment income in Washington state for Ukrainian residents.

This form is used for training and certification for Individual Providers in Washington state who speak Chinese.

This Form is used for Individual Provider Planned Action Notice Training/Certification in the state of Washington. It is available in the Cambodian language.

This Form is used for training and certification of Individual Providers in Washington state who speak Korean.

This form is used for reporting monthly sales and expenses for self-employed individuals in Washington State, specifically for individuals who speak Cambodian. It helps track income and expenses for tax purposes and other financial reporting.

This document is used for reporting the monthly sales and expenses of self-employed individuals in Washington state. It is specifically designed for Lao-speaking individuals.