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
14-151 Request for DDA Eligibility Determination
09-520 Request for Conference Board
18-681 Request for Collection of Uninsured Health Care Expenses
10-277 Request for Children's Out-of-Home Services (Developmental Disabilities Administration)
10-238 Request for an Administrative Hearing (Residential Care Services)
15-436 Request for Adult Family Home Application Fee Waiver Change of Ownership (Home and Community Living Administration)
02-556 Request and Consent for Exception to Policy (ETP) for Use of Restrictive Procedures (Developmental Disabilities)
03-391 Report of Possible Client Assault
17-297 Removal and Transport Directive (Behavioral Health Administration)
27-176 Release of Liability (Developmental Disabilities Administration)