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
16-284 Pre-Occupancy Inspection Checklist (NH Administrator Use) (Residential Care Services)
02-753 Facility Virtual Classroom Training Application and Attestation (Home and Community Services)
27-248 Residential Habilitation for Dependent Youth Acknowledgement (Developmental Disabilities Administration)
17-337 Personal Service Request / Standard Referral (Behavioral Health Administration)
17-337 Personal Service Request / Standard Referral (Developmental Disabilities Administration)
10-709 Request for Residential Habilitation for Dependent Youth Services (Developmental Disabilities Administration)
10-708 Planning for Youth Aged 18-21 Receiving RHDY Services (Developmental Disabilities Administration)
27-247 Residential Habilitation for Dependent Agreement for Youth (Age 18-20) (Developmental Disabilities Administration)
10-707 Residential Habilitation for Dependent Youth (RHDY) Engagement Plan (Developmental Disabilities Administration)
10-706 Lake Burien Transitional Care Facility Dedicated Review Committee (DRC) Determination (Developmental Disabilities Administration)