This version of the form is not currently in use and is provided for reference only. Download this version of DSHS Form 14-012 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.
The document is provided in Albanian. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is DSHS Form 14-012 Consent?
A: DSHS Form 14-012 Consent is a form used in the state of Washington to obtain the consent of individuals for the release of their personal information.
Q: Who uses DSHS Form 14-012 Consent?
A: DSHS Form 14-012 Consent is used by the Washington State Department of Social and Health Services (DSHS) and other organizations authorized to release personal information.
Q: What is the purpose of DSHS Form 14-012 Consent?
A: The purpose of DSHS Form 14-012 Consent is to obtain the written consent of individuals before their personal information is released to other parties.
Q: What information is included in DSHS Form 14-012 Consent?
A: DSHS Form 14-012 Consent includes the individual's name, date of birth, social security number, and a statement of the specific information to be released and the organization to which it will be released.
Form Details:
Download a printable version of DSHS Form 14-012 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.