Washington State Department of Social and Health Services Forms

This form is used for reporting and documenting the resources and expenses of individuals residing in Washington state. It helps the Department of Social and Health Services (DSHS) assess eligibility for various programs and services.

This form is used for notifying the transfer or discharge of residents in adult family homes in the state of Washington.

This Form is used for declaring support payments in Washington state, specifically for Samoan speakers.

This document is used for reporting income, expenses and resources in Washington state. It is available in Amharic language for the convenience of Amharic speakers.

This form is used for reporting your resources and expenses. It is specifically for residents of Washington state who speak Chinese.

This form is used by individuals in Washington to declare support payments. It is available in Tigrinya language.

This form is used for declaring support payments in Washington state. It is available in Trukese language.

This form is used for reporting income, expenses, and resources in Washington state. It is available in Korean language.

This document is used for reporting resources and expenses in Washington for individuals who identify as Marshallese.

This form is used for basic skin assessment in nursing services. It is specifically designed for evaluating the integumentary system, including the skin, hair, and nails. The form is used in the state of Washington by DSHS (Department of Social and Health Services).

This form is used for reporting basic food workfare activities in Washington state. It is available in Somali language.

This Form is used for keeping inventory of personal belongings of residents in adult family homes in Washington state.

This document is used for the withdrawal of a fair hearing request in Washington state.

This Form is used for requesting the withdrawal of a fair hearing in the state of Washington.

This Form is used for withdrawing a fair hearing request in Washington state. This form is available in Tagalog.

This form is used for withdrawing a fair hearing request in Washington state. It is available in Somali language.

This document is for withdrawing a fair hearing request in the state of Washington. It is available in Punjabi.

This form is used for withdrawing a request for a fair hearing in the state of Washington.

This document is used for withdrawing from a fair hearing related to DSHS (Department of Social and Health Services) in Washington state.

This form is used for requesting an exception to policy in Washington State for using restrictive procedures.

This form is used for notifying and reviewing outside employment for companion home providers in Washington state.

This document is a DSHS Formulario 02-611 Declaracion De Entendimiento: Revision Intermedia De Certificacion specific to the state of Washington. It is used for declaring understanding and certification during an intermediate review.

This DSHS Form is used for the mid-certification review process in Washington. It is available in Somali language.

This form is used for the mid-certification review process in Washington to ensure recipients of DSHS benefits understand their rights and responsibilities. The form is available in Tagalog for non-English speakers.