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
15-274 Assistance Available Schedule (DDA)
15-215 DDCS AFH Quality Improvement Visit Assessment (Development Disabilities Community Living / Adult Family Home)
15-184 Volunteer Chore Service Referral
15-031 Nursing Facility Notice of Action
14-555 WA Cares Application Attestation
14-554 Household Application for Sun Bucks
14-553 High School Home Care Aide Training Program and Instructor Application and Updates (Aging and Long-Term Support Administration)
14-552 TED Program Pilot Project: Application for Emergency Alerting Device KIT (Office of the Deaf and Hard of Hearing)
14-551 Adult Family Homes (AFH) State Civil Penalty Reinvestment Program Grant Application
14-550 Job Foundation Application (Developmental Disabilities Administration)