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 Thai. 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 offered by Aging and Long-Term Support Administration and Developmental Disabilities Administration in Washington.
Q: What does Aging and Long-Term Support Administration do?
A: Aging and Long-Term Support Administration provides services and support for older adults and individuals with disabilities in Washington.
Q: What does Developmental Disabilities Administration do?
A: Developmental Disabilities Administration provides services and support for individuals with developmental disabilities in Washington.
Q: What are my rights when receiving services from these administrations?
A: Your rights include the right to be treated with respect, the right to privacy, the right to be involved in making decisions about your services, and the right to file a complaint if you are not satisfied with your services.
Q: What are my responsibilities when receiving services from these administrations?
A: Your responsibilities include providing accurate and complete information, participating in developing your service plan, and treating staff and other clients with respect.
Q: Can I file a complaint if I am not satisfied with my services?
A: Yes, you have the right to file a complaint if you are not satisfied with your services. There is a process in place for addressing and resolving complaints.
Q: Who can I contact if I have questions or need assistance?
A: You can contact the Aging and Disability Services Administration or the Developmental Disabilities Administration for questions or assistance with regards to the services provided.
Q: Are these services available in other languages?
A: Yes, these services are available in languages other than English, including Thai.
Q: What should I do if I believe my rights are being violated?
A: If you believe your rights are being violated, you should contact the appropriate administration to report your concerns and seek resolution.
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.