This version of the form is not currently in use and is provided for reference only. Download this version of DSHS Form 17-041 for the current year.
This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form 17-041?
A: Form 17-041 is the official form used to request DSHS records in Washington.
Q: What information is required on Form 17-041?
A: Form 17-041 requires your personal information, the types of records you are requesting, and any specific details about the records.
Q: Is there a fee for requesting DSHS records?
A: Yes, there may be a fee associated with requesting DSHS records. The fee will depend on the type and quantity of records requested.
Q: How long does it take to process a request for DSHS records?
A: The processing time for a request for DSHS records can vary, but it typically takes several weeks to receive a response.
Q: Can I request DSHS records on behalf of someone else?
A: Yes, you can request DSHS records on behalf of someone else if you have their written consent or legal authorization.
Q: What can I do if my request for DSHS records is denied?
A: If your request for DSHS records is denied, you can appeal the decision by following the instructions provided in the denial letter.
Q: Are there any restrictions on accessing certain DSHS records?
A: Yes, there may be restrictions on accessing certain DSHS records to protect privacy or comply with applicable laws and regulations.
Q: Can I request DSHS records from a previous state of residence?
A: No, you cannot request DSHS records from a previous state of residence using Form 17-041. You will need to contact the appropriate agency in that state.
Form Details:
Download a printable version of DSHS Form 17-041 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.