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
05-010 Rule Exception Request
10-389 Room List For Assisted Living Facilities (ALF)
05-259 Risk, Needs, and Responsivity for Assessments and Treatment Planning (Domestic Violence Intervention Treatment)
10-348 Risk Assessment and Community Protection Program Information Checklist
13-899 Review of Medical Evidence
15-600 Respite, Stabilization, and Residential Health Center (RHC) Support Referral (Developmental Disabilities Administration)
15-381 Respite Assessment Worksheet
10-635 Residential Transition Exchange of Information (Developmental Disabilities Administration)
06-177 Residential Training Roster / Reimbursement (Developmental Disabilities Administration)
15-596 Residential Support Waiver (RSW) Expanded Behavior Supports (EBS) Referral (Home and Community Services)