Washington State Department of Social and Health Services Forms

This form is used for reporting your financial resources and expenses to the Department of Social and Health Services (DSHS) in Washington state. It is available in Burmese language.

This form is used for child care verification in the state of Washington and is available in Russian.

This document is used for verifying Ukrainian child care in the state of Washington through DSHS Form 18-607.

This form is used for requesting the collection of uninsured health care expenses in Washington. It is specifically intended for Chinese speakers.

This form is used for requesting collection of uninsured healthcare expenses in Washington for individuals who speak Hebrew.

This form is used to verify child care services in the state of Washington.

This document provides information about your rights and responsibilities when receiving services from Aging and Disability Services Administration and Developmental Disabilities Administration in Washington state. Available in Vietnamese.

This Form is used for creating a family agreement to enroll children in the Children's Intensive in-Home Behavioral Support (Ciibs) Program in Washington specifically for Cambodian families.

This form is used for making a family agreement to enroll children in the Children's Intensive In-Home Behavioral Support (CIIBS) Program in Washington state.

This form is used for Vietnamese-speaking families in Washington who want to enroll their children in the Children's Intensive In-Home Behavioral Support (CIIBS) Program.

This form is used for the Community Services Division in Washington state to help individuals assess their financial confidence.

This form is used for the Community Services Division (CSD) Financial Confidence Wheel in Washington state. It is available in Somali language.

This Form is used for scheduling a fingerprint appointment at the DSHS office in Washington for individuals of Cambodian nationality.

This document is a Family Agreement form used in Washington for the Children's Intensive in-Home Behavioral Support (Ciibs) Program. It is available in Russian language.

This form is used for scheduling a fingerprint appointment in Washington State for individuals who speak Somali.

This form is used for scheduling a fingerprint appointment for Chinese-speaking individuals in Washington State.

This document is a form used by the Department of Social and Health Services (DSHS) in Washington state to schedule a fingerprint appointment. It is specifically intended for Korean speakers.

This document is a notice for a fingerprint-based background check in Washington state specifically for individuals of Cambodian descent.

This form is used to schedule a fingerprint appointment in Washington State for Russian-speaking individuals.

This Form is used for providing a notice regarding fingerprint-based background checks in the Vietnamese language in the state of Washington.

This form is used for a fingerprint-based background check notice in Washington state for Korean speakers.

This Form is used for a fingerprint-based background check notice in Washington for Somali individuals.

This Form is used for obtaining a fingerprint-based background check notice in Washington state for Chinese individuals.

This form is used for giving permission to share documents for reimbursement of health care expenses in Washington state. Specifically, this is the Chinese version of the form.

This document is used for obtaining a Russian version of the DSHS Form 27-089 RU Fingerprint-Based Background Check Notice in Washington.

This Form is used for authorization of an alternate EBT cardholder in Washington state. It is available in Vietnamese.

This Form is used for authorizing an alternate EBT cardholder in Washington.

This form is used for withdrawing an administrative hearing in the state of Washington for individuals who speak Tigrinya.

This form is used for conducting a disability review in Washington state for individuals who speak Trukese. It helps determine if a person is still eligible for disability benefits.

This Form is used for notifying the Department of Social and Health Services (DSHS) in Washington about the eligibility review for individuals who are turning 19 years old and of Samoan heritage.

This Form is used for completing a state task checklist in Washington state.

This Form is used for reviewing pet records in the state of Washington.

This form is used for creating a staffing pattern for employees in the state of Washington.

This form is used for creating a monthly calendar to plan meaningful activities and events for individuals receiving services from the Washington State Department of Health and Human Services.