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 Punjabi. 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 you receive services offered by Aging and Disability Services Administration and Developmental Disabilities Administration in Washington.
Q: What does Aging and Disability Services Administration (ADSA) do?
A: Aging and Disability Services Administration (ADSA) provides services and support for older adults and individuals with disabilities in Washington.
Q: What does Developmental Disabilities Administration (DDA) do?
A: Developmental Disabilities Administration (DDA) provides services and support for individuals with developmental disabilities in Washington.
Q: What are my rights when I receive services from ADSA and DDA?
A: You have the right to be treated with respect and dignity, to receive information about the services you are eligible for, to be involved in the decision-making process, and to file a complaint if you are not satisfied with the services.
Q: What are my responsibilities when I receive services from ADSA and DDA?
A: Your responsibilities include providing accurate and complete information, following the rules and policies of the programs, and participating in the development of your service plan.
Q: How can I file a complaint if I am not satisfied with the services?
A: You can file a complaint by contacting the program manager or by calling the Complaint Resolution Unit.
Q: What services are provided by ADSA?
A: ADSA provides a range of services, including in-home care, respite care, caregiver support, and long-term care services.
Q: What services are provided by DDA?
A: DDA provides services such as case management, supported employment, residential services, and family support.
Q: Are there any fees for receiving services from ADSA and DDA?
A: The fees for services vary depending on the program and your income level. Some services may be free or offered on a sliding scale basis.
Q: How can I determine if I am eligible for services from ADSA and DDA?
A: You can contact ADSA or DDA to learn about the eligibility criteria for their services.
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.