Electronic DSHS Forms

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.

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Number Form Name(asc) File Format
06-189 Notice of Suspension of Supported Living Services (Developmental Disabilities Administration)
14-535 Notice of Insufficient Information for Reapplication (Developmental Disabilities Administration)
14-460 Notice of Insufficient Information (Developmental Disabilities Administration)
15-342 Notice of Exception to Rule Decision
05-256 Notice of Action Exception to Rule for AFH Daily Rates
05-246 Notice of Action Exception to Rule (Excluding AFH)
14-515 Notice and Finding of Responsibility
27-156 Notice and Consent of Communication via Text or Unencrypted Email
03-374E Nondisclosure of Confidential Information Agreement for Non-Employee (eJAS Access)
16-107 Noncustodial Parent's Rights and Responsibilities
14-057B Noncustodial Parent Child Support Enforcement Application
16-072 NonAssistance Support Enforcement Information (Division of Child Support)
18-399A Non-SSPS Client / Provider Overpayment AFRS Coding Computation
14-440 Non-Profit Organization Application for Reconditioned Telecommunications Equipment (Office of the Deaf and Hard of Hearing)
13-925A Non-Formulary Drug Use Request (Behavioral Health Administration)
17-230 Non-Emergency Medical Transportation (NEMT) for PASRR Program Request
10-664 New or Update Provider Information Worksheet (Developmental Disabilities Administration)
18-463 New Hire Reporting Methods and Instructions (Division of Child Support)
16-244 New Freedom Participant Responsibility Agreement
27-253 New Freedom Authorized Representative (Home and Community Services)
15-601 New Freedom (NF) Notice of Exception to Rule (ETR) Decision (Goods and Services)
27-043 New Contractor Intake
16-201 New Case / Resource Manager Assessment (Developmental Disabilities Administration)
10-382 Naturalization Services Pre-Screening
14-495 Naturalization Letter