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
06-188 Adult Protective Services (APS) Investigations Fact Sheet (Aging and Long-Term Support Administration)
10-665 Alternative Living Provider Application (Home and Community Living Administration)
06-186 Financial Solvency Information (Home and Community Living Administration (HCLA))
16-247 Your Rights and Responsibilities When You Receive MAC or TSOA Services Offered by ALTSA
15-586 Enhanced Services Facility (ESF) Pre-Inspection Packet
15-585 Enhanced Services Facility (ESF) Staff Schedule Worksheet (Residential Care Services)
15-584 Enhanced Services Facility (ESF) Medication Pass Worksheet
15-583 Enhanced Services Facility (ESF) Food Service Observations and Interviews
15-582 Enhanced Services Facility (ESF) Exit Preparation Worksheet
15-581 Enhanced Services Facility (ESF) Notes / Worksheets