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
15-605 Certification Evaluation Checklist Intensive Habilitation Services for Children Providers (Home and Community Living Administration (HCLA)
15-604 Adult Family Home (AFH) Local Building Inspection Checklist (Residential Care Services)
15-603 Enhanced Services Facility Medication Observation Worksheet (Residential Care Services)
15-602 Enhanced Services Facility (ESF) Monitoring Visit (Residential Care Services)
15-601 New Freedom (NF) Notice of Exception to Rule (ETR) Decision (Goods and Services)
15-600 Respite, Stabilization, and Residential Health Center (RHC) Support Referral (Developmental Disabilities Administration)
15-599 Early Engagement of Governor's Opportunity for Supportive Housing (GOSH) Referral (Home and Community Services)
15-597 DDA Youth Transitional Care Facility Admission Checklist (Developmental Disabilities Administration)
15-596 Residential Support Waiver (RSW) Expanded Behavior Supports (EBS) Referral (Home and Community Services)
15-595 Children's Behavior Intervention Plan (Developmental Disabilities Administration)