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 Form File
10-210 Staff Statement of Qualifications
10-631 Staff Qualification and Background Review (Home and Community Living Administration)
10-552 Staff List (Residential Care Services)
10-561 Staff Interview (Residential Care Services)
10-656 Staff and Family Consultation (SFC) 90-Day (Quarterly) Progress Report (Developmental Disabilities Administration)
15-379 Staff Add-on Request for Client Specific Need (Developmental Disabilities Administration))
10-678 Stabilization, Assessment, and Intervention Facility (SAIF) Program Evaluation (Developmental Disabilities Administration)
14-489 SSIF Introduction Letter
10-396 SSI Letter (DDA)
17-123 Spoken Language Interpreter Service Appointment Record