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.

Choose search option and begin typing the form #
Keyword Search
Number(asc) Form Name File Format
10-699 Certified Community Residential Services and Supports (CCRSS) Certification Evaluation Exit Preparation / Exit Conference (Residential Care Services)
10-698 Certified Community Residential Services and Supports (CCRSS) Certification Evaluation Administrator Record Review and Interview (Residential Care Services)
10-697 Emergency Transitional Support Services Certification Evaluation (Developmental Disabilities Administration)
10-696 Assisted Living Facility Medication Observation Worksheet (Residential Care Services)
10-695 Adult Family Home (AFH) Initial Inspection Preparation Checklist (Residential Care Services)
10-693 Group Training Home (GTH) Client Sample Packet (Residential Care Services)
10-692 Group Training Home (GTH) Team Coordinator (TC) Packet (Residential Care Services)
10-691 Certified Community Residential Services and Supports (CCRSS) Client Characteristics (Residential Care Services)
10-690 Nursing Care Consultant Transition Tool (Developmental Disabilities Administration)
10-689 Assisted Living Facility Monitoring Visit (Residential Care Services)
10-688 DDA Specialty Adult Family Home (AFH) Pilot Monthly Client Goal and Progress Report (Developmental Disabilities Administration)
10-687 DDA Specialty Adult Family Home (AFH) Pilot: Strengths, Abilities, Interests, Learn (SAIL) (Developmental Disabilities Administration)
10-685 Companion Home Provider Supplemental Information (Developmental Disabilities Administration)
10-683 Enhanced Services Facility (ESF) Follow-Up (Residential Care Services)
10-682 Childrens Stabilization Habilitation Plan (Developmental Disabilities Administration)
10-681 Group Home (GT) / Client Home Sample Packet (Residential Care Services)
10-680 Certified Community Residential Services and Supports (CCRSS) Group Home (GH) / Client Home Team Coordinator Packet (Residential Care Services)
10-679 Alternative Living Provider Application, Contracting, and Certification Overview Checklist (Developmental Disabilities Administration)
10-678 Stabilization, Assessment, and Intervention Facility (SAIF) Program Evaluation (Developmental Disabilities Administration)
10-677 Certified Community Residential Services and Supports (CCRSS) Certification Evaluation Client Record Review
10-676 Certified Community Residential Services and Supports (CCRSS) Certification Evaluation Client Finances Record Review
10-672 Meaningful Day Eligibility Checklist (Home and Community Services)
10-671 Intensive Habilitation Services for Children Certification Evaluation (Developmental Disabilities Administration)
10-670 Nursing Home Facility License Application (Aging and Long-Term Support Administration)
10-669 Out-of-Home Services (OHS) Transition Checklist (Developmental Disabilities Administrations)