Washington State Department of Social and Health Services Forms

This document is used to verify child care services in Washington State for residents who speak Chamorro language.

This Form is used for accessing the Jobs and Training Inventory in Washington State for Chinese speakers. It helps individuals find employment and training opportunities.

This form is used for converting a Payment Services Only (PSO) case to Full Collection Services in Washington state.

This type of document is used for repaying the state of Washington for medical and long-term services and supports received.

This Form is used for authorizing the Community First Choice Personal Care Services (CCSP) program in Washington State.

This form is used for providing informed consent for ICAP (Integrated Community Assessment and Planning) services in Washington state.

This Form is used for requesting an extension of limitations for certain legal actions in the state of Washington. It serves as a checklist to ensure all required information and documentation are included in the request.

This Form is used for acknowledging the responsibilities of being an employer for individual providers in Washington.

This Form is used for appointment letters regarding the Division of Child Support (DCS) Good Cause Determination in Washington. It provides information and instructions for resolving child support issues.

This document is for notifying individuals in Washington about their responsibility for a certain matter.

This document provides information about your rights as a resident of Washington State. It is used to inform you about the rights and protections available to you under state law.

This form is used for an incapacity review for medical care services in the state of Washington. It helps determine if an individual is eligible for medical care services due to incapacitation.

This form is used for documenting substance use disorder requirements for individuals receiving assistance through the Abd/Pwa program in Washington. It is important for individuals to complete this form accurately to ensure they meet the necessary requirements for continued assistance.

This form is used for gathering feedback and evaluating the effectiveness of person-centered service plan meetings in Washington.

This Form is used for updating the HCBS Waiver Enrollment Database in Washington state.

This Form is used for defining the rights and responsibilities of a noncustodial parent in the state of Washington.

This document provides the DSHS Notice of Privacy Practices for Client Medical Information in Washington. It does not require an acknowledgement from the client.

This Form is used for receiving approval notification for the Home and Community-Based Services (HCBS) waiver in Washington.

This document is used for releasing address information in Washington.

This Form is used for applying for a medical exemption for the influenza vaccination in the state of Washington.

This Form is used for appealing a denial of Supplemental Security Income (SSI) benefits in the state of Washington.

This Form is used for requesting the amendment of Protected Health Information (PHI) in the state of Washington.

This form is used for requesting a residential allowance for shelter expenses in the state of Washington.