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
15-358 Client Referral Summary (Developmental Disabilities Administration)
15-356 DDA Community Protection Program Chaperone Agreement
15-344 Private Duty Nursing Logs and Skilled Nursing Tasks Log
15-342 Notice of Decision (Non-PC) Exception to Rule (Developmental Disabilities Administration)
15-318 Crisis Diversion Bed Referral and Intake Information (Developmental Disabilities Administration)
15-314 Client Necessary Supplemental Accommodation Representative Requirement Checklist
15-304 HCBS Waiver Enrollment Database Update (Developmental Disabilities Administration)
15-295 Person Centered Service Plan Meeting Survey (Developmental Disabilities Administration)
15-291 Person Centered Service Planning and Annual Assessment Meeting Notice (Developmental Disabilities Community Services)
15-290 Notification of Annual Assessment Review and Person Centered Services Planning Meeting