This version of the form is not currently in use and is provided for reference only. Download this version of DSHS Form 10-658 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 Somali. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is DSHS Form 10-658?
A: DSHS Form 10-658 is a report used for Specialized Habilitation in Washington state.
Q: What is Specialized Habilitation?
A: Specialized Habilitation is a program in Washington state that provides services for individuals with developmental disabilities.
Q: What is the purpose of the 90-day (Quarterly) Report?
A: The purpose of the 90-day (Quarterly) Report is to provide an update on the progress of the individual receiving Specialized Habilitation services.
Q: Who needs to fill out this report?
A: The report needs to be filled out by the provider of the Specialized Habilitation services.
Q: Is this form specific to the Somali language?
A: Yes, this form is specifically for the Somali language.
Q: Are there any deadlines for submitting this report?
A: Yes, the report must be submitted within 14 days of the end of the quarter.
Q: What information is required in the report?
A: The report requires information about the goals and objectives of the individual, progress made, and any changes in the individual's circumstances.
Q: Who should I contact if I have questions about this form?
A: You can contact the Washington State Department of Social and Health Services (DSHS) for any questions about this form.
Form Details:
Download a printable version of DSHS Form 10-658 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.