Electronic DSHS Forms

The Electronic DSHS Forms page is a centralized repository where the public can find and download official forms for Washington Department of Social and Health Services programs.

You may download some DSHS forms. These are provided only if a DSHS program requests forms to be available electronically for public use. DSHS forms are available for electronic completion in different software; however, all DSHS forms below are available as Adobe Acrobat PDF files. This means you can open, view, and print each form. To open, view, and print PDF forms, you need to download the free Adobe Acrobat Reader.

We do our best to ensure the links below are accurate; but, if you find a link which does not work, please contact Forms and Records Management.

Number Form Name Sort descending Form File
10-575 Adult Family Home (AFH) Inspection Packet (Residential Care Services)
15-589A Adult Family Home (AFH) Licensing Inspection Floor Plan "Key" (Residential Care Services)
15-589B Adult Family Home (AFH) Licensing: Resident Bedroom / Bathroom Worksheet Continuation (Residential Care Services)
15-604 Adult Family Home (AFH) Local Building Inspection Checklist (Residential Care Services)
02-709 Adult Family Home (AFH) Personnel Changes (Residential Care Services)
15-590 Adult Family Home (AFH) Quality Assurance Visit (Residential Care Services)
10-422 Adult Family Home (AFH) Quality Improvement Initial Visit
15-589C Adult Family Home (AFH) Relocation Initial Licensing Inspection (Residential Care Services)
15-558 Adult Family Home (AFH) Resident Significant Change Assessment Request
10-270 Adult Family Home / Assisted Living Facility / Enhanced Services Facility Admission Agreement(s) Attestation