DSHS Form 09-004C Voluntary Placement Agreement for Child or Youth With Developmental Disabilities - Washington

What Is DSHS Form 09-004C?

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 09-004C?
A: DSHS Form 09-004C is the Voluntary Placement Agreement for Child or Youth With Developmental Disabilities in Washington.

Q: What is the purpose of DSHS Form 09-004C?
A: The purpose of DSHS Form 09-004C is to establish a voluntary placement agreement for a child or youth with developmental disabilities.

Q: Who is this form for?
A: This form is for parents or legal guardians of a child or youth with developmental disabilities who wish to voluntarily place them in a residential facility.

Q: What does the form require?
A: The form requires information about the child or youth, the parent or guardian, the residential facility, and the terms of the placement agreement.

Q: How should the form be filled out?
A: The form should be filled out completely and accurately, providing all necessary information and signatures.

Q: Are there any fees associated with submitting this form?
A: No, there are no fees associated with submitting DSHS Form 09-004C.

Q: What happens after the form is submitted?
A: Once the form is submitted, it will be reviewed by DSHS to ensure it is complete and meets the requirements. If approved, a placement agreement will be established.

Q: Can the placement agreement be terminated?
A: Yes, the placement agreement can be terminated by either party with proper notice and accordance with the terms outlined in the agreement.

Q: What if I have more questions or need assistance with the form?
A: If you have more questions or need assistance with DSHS Form 09-004C, you can contact the Washington State Department of Social and Health Services (DSHS) for further guidance.