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This version of the form is not currently in use and is provided for reference only. Download this version of
DSHS Form 01-212
for the current year.
DSHS Form 01-212 Nurse Delegation Referral and Communication - Washington
What Is DSHS Form 01-212?
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.
FAQ
Q: What is DSHS Form 01-212?
A: DSHS Form 01-212 is the Nurse Delegation Referral and Communication form used in Washington.
Q: What is nurse delegation?
A: Nurse delegation is the process of assigning certain nursing tasks to unlicensed assistive personnel under the supervision of a registered nurse.
Q: Why is DSHS Form 01-212 used?
A: DSHS Form 01-212 is used to facilitate communication and documentation between registered nurses and unlicensed assistive personnel regarding nurse delegation tasks.
Q: Who needs to complete DSHS Form 01-212?
A: Both the registered nurse and the unlicensed assistive personnel involved in nurse delegation tasks need to complete DSHS Form 01-212.
Form Details:
- Released on June 1, 2021;
- The latest edition provided by the Washington State Department of Social and Health Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of DSHS Form 01-212 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.
Download DSHS Form 01-212 Nurse Delegation Referral and Communication - Washington
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