PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
DSHS Form 03-374E
for the current year.
DSHS Form 03-374E Confidential Information, Fraud and Abuse - Washington
What Is DSHS Form 03-374E?
This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is DSHS Form 03-374E?
A: DSHS Form 03-374E is a document used in Washington to report confidential information, fraud, and abuse to the Department of Social and Health Services (DSHS).
Q: Who uses DSHS Form 03-374E?
A: Anyone who has information about confidential information, fraud, or abuse in the DSHS system can use this form to report it.
Q: What is the purpose of DSHS Form 03-374E?
A: The purpose of this form is to provide a way for individuals to report any concerns they have regarding confidential information, fraud, or abuse within the DSHS program.
Q: What information should be included on DSHS Form 03-374E?
A: The form requires you to provide details such as your name, contact information, and a comprehensive description of the confidential information, fraud, or abuse that you are reporting.
Q: Is DSHS Form 03-374E anonymous?
A: Yes, you have the option to remain anonymous when submitting DSHS Form 03-374E. However, providing your contact information may assist in the investigation and resolution of the reported concern.
Q: What happens after submitting DSHS Form 03-374E?
A: After submitting the form, DSHS will review the information provided and take appropriate action, which may include an investigation into the reported concerns.
Q: Can I report confidential information, fraud, or abuse by phone?
A: Yes, in addition to using DSHS Form 03-374E, you can also report confidential information, fraud, or abuse by calling the DSHS Fraud Hotline at [insert phone number].
Q: Is there a deadline for submitting DSHS Form 03-374E?
A: While there is no specific deadline mentioned, it is recommended to submit the form as soon as possible after becoming aware of the confidential information, fraud, or abuse.
Q: Is reporting false information on DSHS Form 03-374E illegal?
A: Yes, providing false information on DSHS Form 03-374E is considered a crime and may lead to legal consequences.
Form Details:
- Released on November 1, 2014;
- The latest edition provided by the Washington State Department of Social and Health Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of DSHS Form 03-374E by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.
