Public Disclosure Request
DBHR complies with the public disclosure requirements of RCW 42.56. In DSHS, each division has a Public Disclosure Coordinator. Requests for disclosure of public information of DBHR records should be sent to:
Judy Combes, DBHR Public Disclosure Coordinator
P.O. Box 45330 (Mail Stop 45330)
Olympia, WA 98504-5330
Phone 360-725-3728 or Toll Free 1-877-301-4557
Fax 360-725-2279
Public Disclosure Forms
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Authorization DSHS 17-063 ( Word ) ( PDF ) (Purpose: Use this form to request the release of your confidential patient/client information held by DSHS to another party.) PDF Translations: Arabic, Cambodian, Chinese, Croatian, Farsi, Hmong, Japanese, Korean, Laotian, Marshallese, Polish, Romanian, Russian, Samoan, Somali, Spanish, Tagalog, Tigrinya, Vietnamese
