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.
Q: What is DSHS Form 16-172?
A: DSHS Form 16-172 is a document that explains your rights and responsibilities when receiving services from Aging and Long-Term Support Administration and Developmental Disabilities Administration in Washington.
Q: What services are offered by Aging and Long-Term Support Administration and Developmental Disabilities Administration?
A: Aging and Long-Term Support Administration and Developmental Disabilities Administration offer services for elderly individuals and individuals with developmental disabilities in Washington.
Q: What are my rights when receiving services from Aging and Long-Term Support Administration and Developmental Disabilities Administration?
A: When receiving services from Aging and Long-Term Support Administration and Developmental Disabilities Administration, you have the right to be treated with respect, dignity, and privacy.
Q: What are my responsibilities when receiving services from Aging and Long-Term Support Administration and Developmental Disabilities Administration?
A: When receiving services from Aging and Long-Term Support Administration and Developmental Disabilities Administration, you have the responsibility to provide accurate and complete information and to follow the rules and guidelines set by the program.
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.