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 Polish. 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 offered by the Aging and Long-Term Support Administration and Developmental Disabilities Administration in Washington.
Q: Who provides the services mentioned in DSHS Form 16-172?
A: The services mentioned in DSHS Form 16-172 are provided by the Aging and Long-Term Support Administration and Developmental Disabilities Administration in Washington.
Q: What does DSHS stand for?
A: DSHS stands for the Department of Social and Health Services.
Q: What are some of the rights mentioned in DSHS Form 16-172?
A: Some of the rights mentioned in DSHS Form 16-172 include the right to be treated with respect and dignity, the right to privacy, and the right to receive services in a timely manner.
Q: What are some of the responsibilities mentioned in DSHS Form 16-172?
A: Some of the responsibilities mentioned in DSHS Form 16-172 include the responsibility to provide accurate information, the responsibility to follow program rules, and the responsibility to participate in the development of your service plan.
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.