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
10-574C Transitional Care Planning Tracking: Part C. Post Move and Stabilization (Developmental Disabilities Administration)
10-574B Transitional Care Planning and Tracking: Part B. Active Coordinator of Transition (ACT) (Developmental Disabilities Administration)
10-574A Transitional Care Planning and Tracking: Part A. Transition Preparation (Developmental Disabilities Administration)
17-345 Transitional Care Management Exchange of Information (Developmental Disability Administration)
19-074 Transfer / Loan / Recovery Agreement (Division of Vocational Rehabilitation)
13-906 Therapy Evaluation for Bed Transfer / Positioning Devices (Typically Bed or Side Rails) (Home and Community Services)
10-437 Temporary Manager and/or Receiver Application Nursing Home and Assisted Living Facility
02-586 Temporary Employment Hours Tracking Log
27-215 Teleservice Agreement (Developmental Disabilities Administration)
14-427 Teen Parent Living Assessment