This version of the form is not currently in use and is provided for reference only. Download this version of DSHS Form 16-172 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 DSHS Form 16-172?
A: DSHS Form 16-172 is a document about your rights and responsibilities when receiving services from Aging and Disability Services Administration and Developmental Disabilities Administration in Washington.
Q: What does DSHS stand for?
A: DSHS stands for Department of Social and Health Services.
Q: What services are offered by Aging and Disability Services Administration?
A: Aging and Disability Services Administration offers various services for older adults and people with disabilities, such as long-term care, in-home care, and support services.
Q: What services are offered by Developmental Disabilities Administration?
A: Developmental Disabilities Administration offers services for individuals with developmental disabilities, including residential support, employment assistance, and community inclusion programs.
Q: What are your rights when receiving services?
A: When receiving services, you have the right to be treated with respect, to participate in your care plan, to have your privacy protected, and to file a complaint if needed.
Q: What are your responsibilities when receiving services?
A: When receiving services, you have the responsibility to provide accurate information, to follow the rules and regulations, and to cooperate with the service providers.
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.