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 Samoan. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is DSHS Form 16-172?
A: DSHS Form 16-172 is a document which outlines your rights and responsibilities when you receive services offered by Aging and Long-Term Support Administration and Developmental Disabilities Administration in Washington (Samoan).
Q: What does the document cover?
A: The document covers the rights and responsibilities you have as a recipient of services offered by Aging and Long-Term Support Administration and Developmental Disabilities Administration in Washington (Samoan).
Q: Who is this document for?
A: This document is for individuals who receive services offered by Aging and Long-Term Support Administration and Developmental Disabilities Administration in Washington (Samoan).
Q: What should I do if I have questions about my rights and responsibilities?
A: If you have questions about your rights and responsibilities, you should contact Aging and Long-Term Support Administration and Developmental Disabilities Administration in Washington (Samoan) for assistance.
Form Details:
Download a printable version of DSHS Form 16-172 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.