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 Kurdish. 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 Disability Services Administration and Developmental Disabilities Administration in Washington state.
Q: Who does DSHS Form 16-172 apply to?
A: DSHS Form 16-172 applies to individuals receiving services offered by the Aging and Disability Services Administration and Developmental Disabilities Administration in Washington state.
Q: What rights do you have when receiving services?
A: When receiving services, you have the right to be treated with respect and dignity, to be informed about your options and choices, and to have your privacy protected.
Q: What are your responsibilities when receiving services?
A: When receiving services, it is your responsibility to provide accurate information, to participate in your service planning, and to follow program rules and guidelines.
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.