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 22-171?
A: DSHS Form 22-171 is a discrimination complaint form in Washington state.
Q: What is the purpose of DSHS Form 22-171?
A: The purpose of DSHS Form 22-171 is to file a complaint if you believe you have been discriminated against.
Q: Who can file a discrimination complaint using DSHS Form 22-171?
A: Any individual who believes they have been discriminated against by DSHS (Department of Social and Health Services) can file a complaint using this form.
Q: What should be included in the complaint form?
A: The complaint form should include details about the discrimination incident, such as date, time, location, and a description of what happened.
Q: Is there a deadline for filing a discrimination complaint?
A: Yes, there is a deadline for filing a discrimination complaint. It is recommended to file the complaint within 180 days of the alleged discrimination.
Q: Is language assistance available for filling out the form?
A: Yes, language assistance, including translation services, can be requested to help fill out the form.
Q: Are there any fees associated with filing a discrimination complaint?
A: No, there are no fees associated with filing a discrimination complaint using DSHS Form 22-171.
Q: What happens after the discrimination complaint is filed?
A: After the discrimination complaint is filed, DSHS will conduct an investigation to determine if there was any discrimination.
Q: What are the possible outcomes of the investigation?
A: The possible outcomes of the investigation include finding that discrimination occurred, finding that discrimination did not occur, or finding that there is not enough evidence to support a conclusion.
Form Details:
Download a fillable version of DSHS Form 22-171 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.