Providers Order Form: Washington State Division of Child Support
Washington State Department of Social and Health Services Home page

Division of Child Support

How to order materials:

Paternity Materials Order Form

If you are a parent who needs to receive a Washington State Paternity Acknowledgment for personal use, do not use this on-line ordering form. Instead, please call 1-800-442-5437. The receptionist can arrange to mail you the acknowledgment form and other written information.
Hospital or organization name:
Name of operating unit
(if hospital):
Street Address:
Please do not use PO Box

Person placing the Order:
First Name:Last Name:

Materials you may order on-line:
Paternity Acknowledgment (DOH/CHS 021)
How many in English?
How many in Spanish?
Establish Parentage for Your Child's Sake
Brochure (DSHS 22-586)
How many in English?
How many in Spanish?
Acknowledgment Video 
How many in DVD format (contains English and Spanish)?
Voluntary Paternity Testing Program (DSHS 22-1443)
Note: replaces Bright Start: How to Get a Genetic Test, DSHS 22-959 effective July, 2011

(for participating hospitals only)
How many in English?
How many in Spanish?