Washington State Department of Social and Health Services Forms

This Form is used to apply for Telecommunications Equipment in Washington State.

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

This Form is used for making a service request contact notice in Washington for the Russian-speaking population.

This form is used for requesting contact information for services in Washington State. It is available in Somali language.

This document is used for submitting a service request contact notice to the Department of Social and Health Services (DSHS) in the state of Washington. It is available in the Lao language.

This form is used for requesting contact notice services in Washington State, specifically for Korean speakers.

This form is used for evaluating the quality assurance of residential care provided by alternative living providers for individuals with developmental disabilities in the state of Washington.

This document is a State Supplementary / Direct Payment Client Overpayment Notice form specific to the state of Washington. It is available in the Korean language.

This Form is used for notifying clients in Washington state about overpayments in state supplementary or direct payments.

This Form is used for the intake of individual providers who want to contract with the Washington Department of Social and Health Services (DSHS) for Home and Community Services (HCS), Area Agencies on Aging (AAA), and Developmental Disabilities Administration (DDA). The form is available in Portuguese.

This Form is used for releasing liability in relation to developmental disabilities in the state of Washington. (Available in Korean)

This Form is used for the Discharge of Liability in Washington.

This document is used for releasing liability in relation to developmental disabilities in Washington.