Washington State Department of Social and Health Services Forms

This form is used for reporting disabilities to the Washington State Department of Social and Health Services (DSHS). It is available in both English and Tigrinya languages.

This document is used for wrapping up an assessment meeting with the Washington Department of Social and Health Services (DSHS).

This document is a Naturalization Letter specific to the state of Washington for the Haka-Chin community. It is used during the process of becoming a naturalized citizen.

This Form is used for submitting a naturalization letter as part of the citizenship application process in Washington state. The form is available in Gujarati, a language spoken in the state of Gujarat in India.

This form is used for notifying individuals about their annual assessment review and person-centered services planning meeting in the state of Washington.

This form is used for requesting admission to an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) or a State-Operated Nursing Facility (SONF) in Washington state.

This Form is used for requesting contact information changes for service requests in the state of Washington.

This type of document is used for obtaining information about financial resources and expenses in Washington state. It is available in French.

This document is a detail sheet for uninsured health care expenses in Washington state. It is used to provide detailed information about medical expenses incurred by individuals who do not have health insurance. It is written in Russian.

This form is used for releasing liability in the state of Washington.

This form is used for vendors in Washington to declare a lost, stolen, or destroyed warrant. It specifically targets the Cambodian community.

This form is used for applying for disaster food benefits in Washington state for individuals who speak Lao.

This form is used for recording attendance at outreach events in the state of Washington.

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

This form is used for conducting disability reviews in the state of Washington. It is available in the Gujarati language.

This form is used for notifying the Department of Social and Health Services in Washington about the expiration of eligibility for certain benefits at age 18.

This form is used for notifying residents in Washington when their eligibility for certain services ends at age 20.

This Form is used for referring child support cases in Washington with Cambodian language assistance.

This Form is used for applying for disaster food benefits in Washington for Cambodian residents during times of emergencies or disasters.

This document is the DSHS Form 12-206 Application for Disaster Food Benefits in Washington State. It is specifically for Chinese-speaking individuals who are applying for assistance following a disaster.

This document is used for applying for child support enforcement in Washington for noncustodial parents who are Cambodian.

This document is used for requesting the disclosure of address information in the state of Washington. It is available in Korean.

This Form is used for requesting the disclosure of address information in Washington state for individuals of Lao heritage.

This Form is used for requesting a disability review in the state of Washington through the Washington State Department of Social and Health Services (DSHS).

This form is used for understanding the options available for child support collection while receiving Temporary Assistance for Needy Families (TANF) in Washington for Marshallese residents.

This Form is used for declaring support payments in Washington (Mien)

This Form is used for determining the character, competence, and suitability of individuals who seek unsupervised access to minors and vulnerable adults in the state of Washington. It helps to ensure the safety and protection of these vulnerable populations.

This Form is used for vendors in Washington to report lost, stolen, or destroyed warrants. It is available in Korean language.

This form is used for creating a summary report of student evaluations in Washington state.