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DSHS Form 15-419 Refusal of Services Statement - Washington
What Is DSHS Form 15-419?
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 15-419?
A: DSHS Form 15-419 is the Refusal of Services Statement used in Washington State.
Q: What does DSHS stand for?
A: DSHS stands for the Department of Social and Health Services.
Q: What is the purpose of DSHS Form 15-419?
A: The purpose of DSHS Form 15-419 is to allow individuals to refuse certain social or health services provided by the state.
Q: Who needs to use DSHS Form 15-419?
A: Anyone who wishes to refuse social or health services provided by the state of Washington may use DSHS Form 15-419.
Q: Is DSHS Form 15-419 mandatory to refuse services?
A: No, DSHS Form 15-419 is not mandatory to refuse services, but it is recommended to provide a written statement for documentation purposes.
Q: Can I change my mind after submitting DSHS Form 15-419?
A: Yes, you can change your mind at any time and revoke your refusal of services by notifying the Department of Social and Health Services in writing.
Q: Are there any consequences for refusing services using DSHS Form 15-419?
A: No, there are no consequences for refusing services using DSHS Form 15-419. It is your right to refuse services provided by the state.
Form Details:
- Released on October 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 15-419 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.
