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 Cambodian. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is DSHS Form 17-041?
A: DSHS Form 17-041 is a request form for DSHS records in Washington.
Q: What kind of records can be requested with DSHS Form 17-041?
A: DSHS Form 17-041 can be used to request various types of records maintained by the Washington State Department of Social and Health Services.
Q: Who can use DSHS Form 17-041?
A: Any individual or entity who wants to request DSHS records in Washington can use DSHS Form 17-041.
Q: Is DSHS Form 17-041 specific to the Cambodian language?
A: Yes, DSHS Form 17-041 is specifically available in the Cambodian language.
Q: Is there a fee for requesting DSHS records using Form 17-041?
A: Yes, there may be a fee associated with requesting DSHS records using Form 17-041. The fee amount and payment details can be found on the form itself or by contacting the DSHS.
Q: How long does it take to receive requested DSHS records?
A: The time it takes to receive requested DSHS records can vary depending on the nature and availability of the records. It is recommended to contact the DSHS for more information on processing times.
Q: Can I request DSHS records in a language other than Cambodian?
A: Yes, DSHS Form 17-041 is available in multiple languages, including English. You can request DSHS records in the language of your choice.
Q: Are there any specific requirements for submitting DSHS Form 17-041?
A: Yes, there are certain requirements for submitting DSHS Form 17-041, such as providing accurate and complete information, including necessary identification documents, and submitting the form via the designated methods outlined on the form.
Q: Can I request DSHS records for someone else using Form 17-041?
A: Yes, you can request DSHS records for someone else using Form 17-041. However, you may need to provide additional documentation or authorization depending on your relationship to the person and the nature of the records being requested.
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.