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 Cambodian. 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 that outlines your rights and responsibilities when receiving services from the Aging and Long-Term Support Administration and Developmental Disabilities Administration in Washington state.
Q: Who is this document for?
A: This document is for individuals in Washington state who receive services from the Aging and Long-Term Support Administration and Developmental Disabilities Administration.
Q: What does the document cover?
A: The document covers your rights and responsibilities when receiving services, including information on confidentiality, decision-making, complaints, and more.
Q: What is the purpose of this document?
A: The purpose of this document is to inform individuals receiving services about their rights and to ensure that they understand their responsibilities.
Q: Is this document available in other languages?
A: Yes, this document is available in multiple languages, including Cambodian.
Q: What should I do if I have questions or concerns about my rights and responsibilities?
A: If you have questions or concerns about your rights and responsibilities, you should contact the Aging and Long-Term Support Administration or Developmental Disabilities Administration 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.