1.  How do I apply and what forms do I need for state certification as a new chemical dependency treatment provider?

Below are forms to fill out to send back to the DBHR Certification Provider Request Manager for state certification as a new chemical dependency treatment provider:

• New Service Provider Certification
  Application Form [WORD] (fill-in form) or [PDF]
  Instructions and FAQs [WORD] or [PDF]
   
• Branch Application Form
  and Instructions
   
• Background Check Resource Guide
   
• Criminal Background check form (from Washington State Patrol)  
  [PDF Fill-In]  
  Must use the Request for Child/Adult Abuse Info Act form. To access the form in Word or PDF, click on "FORMS" on the WSP WATCH website https://watch.wsp.wa.gov/Help?Index=forms
   
• Sample Floor Plan [PDF] or [Word]
   
• American with Disabilities Act (ADA) Checklist for Existing Facilities (needed for agency applications & relocations)
   
• Off-site Information Packet  

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