DSHS Form 14-416 Eligibility Review for Long Term Services and Supports - Washington (Somali)

This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington.

The document is provided in Somali. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the DSHS Form 14-416?
A: The DSHS Form 14-416 is the Eligibility Review for Long-Term Services and Supports (LTSS) in Washington.

Q: Who is this form for?
A: This form is for Somali-speaking individuals in Washington who are applying for or receiving long-term services and supports.

Q: What is the purpose of this form?
A: The purpose of this form is to review and determine the eligibility for long-term services and supports.

Q: What information do I need to provide on this form?
A: You will need to provide personal information, income and assets, medical history, and details about the long-term services and supports you are receiving or need.

Q: How long does it take to complete this form?
A: The time to complete this form may vary depending on your individual circumstances, but it is important to provide accurate and thorough information.

Q: What should I do if I need help filling out this form?
A: If you need assistance with filling out this form, you can reach out to a Somali-speaking staff member at DSHS or a community organization that provides language support.

Q: What happens after I submit this form?
A: After you submit this form, DSHS will review your information and determine your eligibility for long-term services and supports. They may contact you for additional information or clarification if needed.

Q: How often do I need to complete this form?
A: The frequency of completing this form may vary depending on your circumstances. Typically, it is done on an annual or as-needed basis to review and update your eligibility.