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
27-253 New Freedom Authorized Representative (Home and Community Services)
15-601 New Freedom (NF) Notice of Exception to Rule (ETR) Decision (Goods and Services)
27-043 New Contractor Intake
16-201 New Case / Resource Manager Assessment (Developmental Disabilities Administration)
10-382 Naturalization Services Pre-Screening
14-495 Naturalization Letter
02-531 Native Language Identifier
10-661 Music Therapy 90-Day (Quarterly) Report (Developmental Disabilities Administration)
11-067 Monthly Budget Worksheet (Division of Vocational Rehabilitation)
10-334 Monitoring of Side Effects Scale (MOSES) (DDA)