DSHS Form 13-021 Physical Evaluation - Washington

What Is DSHS Form 13-021?

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 13-021?
A: DSHS Form 13-021 is a form used for physical evaluation in the state of Washington.

Q: Who uses DSHS Form 13-021?
A: This form is used by individuals seeking certain services from the Washington State Department of Social and Health Services (DSHS).

Q: What is the purpose of the physical evaluation?
A: The physical evaluation helps determine an individual's physical abilities and limitations in order to determine eligibility for specific services.

Q: Do I need to fill out the form myself?
A: No, the physical evaluation form needs to be completed by a qualified healthcare provider, such as a physician or nurse practitioner.

Q: What information is required on the form?
A: The form will typically ask for personal information, medical history, current medications, and details about the individual's physical abilities and limitations.

Q: Is there a fee for the physical evaluation?
A: Fees for the physical evaluation may vary. Contact your local DSHS office for more information on any associated fees.

Q: How long does it take to complete the physical evaluation?
A: The duration of the physical evaluation can vary depending on the complexity of the individual's medical condition and the required assessments.

Q: What happens after the physical evaluation?
A: After the evaluation, the healthcare provider will submit the completed form to the Washington State Department of Social and Health Services (DSHS). The DSHS will then review the information to determine eligibility for specific services.

Q: Can I appeal the results of the physical evaluation?
A: Yes, if you disagree with the determination made based on the physical evaluation, you have the right to appeal the decision. Contact the DSHS office for information on the appeals process.