Frequently Requested Forms

Form Title Form Number Purpose
Adoption Support Agreement Review DSHS 10-082 Review Paperwork
Adoption Support Limitation Letter DSHS 10-547 Describes program limitations
Direct Deposit Direct Deposit Instruction and Registration for Direct Deposit
Disability Statement at 18 DSHS 15-412 Documentation
Preauthorization  for Services DSHS 10-214 To be completed by parent, therapist, and adoption support program consultant prior to providing service
Vendor Affidavit of Lost, Stolen or Destroyed Warrant DSHS 09-013 To report lost or stolen warrant
Waiver of Right to Receive Written Information on Adoption Support Program Limitation DSHS 27-121 Waives the right of receiving information