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 Form Name(desc) File Format
10-244 Child and Family Engagement Plan (Developmental Disabilities)
10-471 Child and Family Team (CFT) Care Plan (Developmental Disabilities Administration)
18-607 Child Care Verification
09-741 Child Support Order Review Request
14-057 Child Support Referral
14-057D Child Support Referral Continuation
15-595 Children's Behavior Intervention Plan (Developmental Disabilities Administration)
16-230 Children's Residential Services
21-059 Children's Staffed Residential Quality Assurance Assessment
10-649 Children's State Operated Living Alternatives (SOLA) Certification Evaluation (Developmental Disabilities Administration)
10-682 Childrens Stabilization Habilitation Plan (Developmental Disabilities Administration)
21-060 Children’s State Operated Living Alternative (SOLA) Quality Assurance Assessment
12-209 Client Fraud Report
15-314 Client Necessary Supplemental Accommodation Representative Requirement Checklist
18-398 Client Overpayment Notice
15-358 Client Referral Summary (Developmental Disabilities Administration)
18-720 Client Responsibility Notice (Home and Community Services)
05-252 Code of Ethics and Standards of Practice (Division of Vocational Rehabilitation)
14-431A Community Crisis Stabilization Services (CCSS) Medical / Dental Services Authorization (Developmental Disabilities Administration)
10-660 Community Engagement Quarterly Progress Report (Developmental Disabilities Administration)
15-550 Community Instructor Application (Home and Community Services)
15-549 Community Instructor Application: DSHS Adult Education (Home and Community Services)
02-692 Community Instructor Class List Tracking Log
10-641 Community Instructor Qualification Tool (Home and Community Services)
15-551 Community Instructor Training Program Application and Updates (Home and Community Services)