PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
DSHS Form 13-917
for the current year.
DSHS Form 13-917 Ccss Medical / Dental Services Authorization (Community Crisis Stabilization Services) - Washington
What Is DSHS Form 13-917?
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 13-917?
A: DSHS Form 13-917 is a Medical/Dental Services Authorization for Community Crisis Stabilization Services in Washington.
Q: What does the form authorize?
A: The form authorizes medical and dental services for Community Crisis Stabilization Services.
Q: Who is this form for?
A: This form is for individuals receiving Community Crisis Stabilization Services in Washington.
Q: Do I need to fill out this form?
A: If you are receiving Community Crisis Stabilization Services in Washington, you may need to fill out this form to authorize medical and dental services.
Form Details:
- Released on December 1, 2018;
- 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 13-917 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.
