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 Japanese. 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.
Q: What does the form cover?
A: The form covers the rights and responsibilities you have as a recipient of services offered by the Aging and Long-Term Support Administration and Developmental Disabilities Administration.
Q: What are some of the rights mentioned in the form?
A: Some of the rights mentioned in the form include the right to be treated with respect and dignity, the right to receive services in the least restrictive setting, and the right to participate in the planning and decision-making process.
Q: What are some of the responsibilities mentioned in the form?
A: Some of the responsibilities mentioned in the form include providing accurate information, following rules and guidelines, and actively participating in your own care and service planning.
Q: Who is the form intended for?
A: The form is intended for individuals who receive services from the Aging and Long-Term Support Administration and Developmental Disabilities Administration in Washington.
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.