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
10-722 State-Operated Community Residential Transitions Program (SOCR-T) Certification Evaluation Checklist (Home and Community Living Administration)
11-163 Applicant Certification and Assurances (Division of Vocational Rehabilitation)
15-557 Behavior Support Consultation and/or Training Request (Home and Community Services)
06-191 DPI College Financial Aid Request (Division of Program Integrity)
11-110A Service Delivery Outcome Plan (SDOP): Informational Interview (Division of Vocational Rehabilitation)
11-132 90 Day Review (Division of Vocational Rehabilitation)
17-226 AAA Systems Access Request (SAR) for DSHS / HCS / ESD Systems
14-541 ABAWD Requirement: Medical Report (Able Bodied Adults without Dependents)
14-526 ABD, PWA, and HEN Referral Substance Use Disorder Treatment Verification
01-205 Able Bodied Adults Without Dependents (ABAWD) Activity Report