Washington State Department of Social and Health Services Forms

This form is used for enrolling in direct deposit for DSHS benefits in Washington state. It is available in Marshallese language.

This document is for residents of Washington who want to review their eligibility for long-term services and supports. It is available in Ilocano.

This Form is used for scheduling an interview appointment for applicants in emergency situations in Washington. It is available in Pashto language.

This form is used for acknowledging the responsibilities of employers during the COVID-19 pandemic for individual providers in Washington. It is available in Haitian Creole.

This form is used as an attachment to gather contact information during an interview conducted by the DSHS (Department of Social and Health Services) in Washington.

This form is used for noting and documenting information related to Enhanced Services Facilities (ESF) in Washington state. It includes worksheets and notes for DSHS Form 15-581 Attachment K.

This form is used for recording medication passes in Washington for the Emergency Support Function (ESF) Medication Program.

This document is used for reporting environmental observations in Washington state, as an attachment to DSHS Form 15-577.

This form is used for creating a resident list for an Enhanced Services Facility (ESF) in Washington state.

This document is used for notifying individuals in Washington who are required to undergo a fingerprint-based background check.

This form is used for authorizing the verification of assets in Washington State.

This document is used to request a review of a child support order in Washington, but it is in Swahili.