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(asc) | File Format | |
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18-551 | School Statement |
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10-427 | School District Communication | ||
05-010 | Rule Exception Request | ||
15-560 | Room Requirements Checklist (Home and Community Services) | ||
10-389 | Room List For Assisted Living Facilities (ALF) | ||
05-259 | Risk, Needs, and Responsivity for Assessments and Treatment Planning (Domestic Violence Intervention Treatment) | ||
13-899 | Review of Medical Evidence | ||
15-381 | Respite Assessment Worksheet | ||
10-635 | Residential Transition Exchange of Information (Developmental Disabilities Administration) | ||
06-177 | Residential Training Roster / Reimbursement (Developmental Disabilities Administration) | ||
15-596 | Residential Support Waiver (RSW) Expanded Behavior Supports (EBS) Referral (Home and Community Services) | ||
11-130 | Residential Support Waiver (RSW) Expanded Behavior Supports (EBS) Eligibility Determination (Home and Community Services) | ||
10-328 | Residential Site Approval Request | ||
10-403 | Residential Services Provider: Mandatory Reporting of Abuse, Neglect, Personal and Financial Exploitation, or Abandonment of a Child or Vulnerable Adult | ||
15-360 | Residential Services Capacity Profile | ||
05-274 | Residential Referral Transition (Developmental Disabilities Administration) | ||
15-564 | Residential Quarterly Report for Children's Residential Services (Developmental Disabilities Administration) | ||
10-666 | Residential Quality Assurance Certification Evaluation Checklist for Overnight Planned Respite Services Providers (Developmental Disabilities Administration) | ||
17-295 | Residential Quality Assurance Certification Evaluation Checklist for Companion Homes Providers (Developmental Disabilities Administration) | ||
17-296 | Residential Quality Assurance Certification Evaluation Checklist for Alternative Living Providers (Developmental Disabilities Administration) | ||
02-632 | Residential Provider's Report of Weapon Ownership in Residential Setting | ||
15-494 | Residential Habilitation Center (RHC) / Individual Habilitation Plan (IHP) / Individual Plan of Care (IPOC) Meeting Notification (Developmental Disabilities Administration) | ||
10-647 | Residential Certification Evaluation Staff Interview (Developmental Disabilities Administration) | ||
10-646 | Residential Certification Evaluation Legal Representative Interview (Developmental Disabilities Administration) | ||
10-645 | Residential Certification Evaluation Client Interview (Developmental Disabilities Administration) |