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
10-423 Shared Planning for Youth Aged 18-21 Receiving Voluntary Placement Services
10-104B Service Verification / Attendance Record For Alternative Living Providers (Developmental Disabilities Administration)
15-501 Service Request Contact Notice (Developmental Disabilities Community Services)
11-097 Service Delivery Outcome Report: IL (Independent Living Services) (Division of Vocational Rehabilitation)
11-030 Service Delivery Outcome Report (SDOR) (Division of Vocational Rehabilitation)
11-125 Service Delivery Outcome Plan: WBL - Experience C
11-124 Service Delivery Outcome Plan: WBL - Experience B
11-123 Service Delivery Outcome Plan: WBL - Experience A
11-112 Service Delivery Outcome Plan: Job Shadow - Pre-ETS (Pre-Employment Transition Services) (Division of Vocational Rehabilitation)
11-110 Service Delivery Outcome Plan (SDOP): Informational Interview Pre-ETS (Pre-Employment Transition Services) (Division of Vocational Rehabilitation)