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 ascending Form File
13-780 Nursing Services Basic Skin Assessment (Home and Community Services)
13-784 Nursing Services Assessment
10-237 Nursing Home Transfer or Discharge Notice (Residential Care Services)
10-603 Nursing Home Information Changes
27-209 Nursing Home Informal Dispute Resolution Request (Residential Care Services)
10-670 Nursing Home Facility License Application (Home and Community Living Administration)
15-031 Nursing Facility Notice of Action
10-690 Nursing Care Consultant Transition Tool (Developmental Disabilities Administration)
10-713 Nursing Care Consultant (NCC) Focused Assessment (Developmental Disabilities Administration)
10-339 Nursing Care Consultant (NCC) Assessment (Developmental Disabilities Community Services (DDCS))