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.
| Number(desc) | Form Name | File Format | |
|---|---|---|---|
| 10-680 | Certified Community Residential Services and Supports (CCRSS) Group Home (GH) / Client Home Team Coordinator Packet (Residential Care Services) | ||
| 10-681 | Group Home (GT) / Client Home Sample Packet (Residential Care Services) | ||
| 10-682 | Childrens Stabilization Habilitation Plan (Developmental Disabilities Administration) | ||
| 10-683 | Enhanced Services Facility (ESF) Follow-Up (Residential Care Services) | ||
| 10-685 | Companion Home Provider Supplemental Information (Developmental Disabilities Administration) | ||
| 10-687 | DDA Specialty Adult Family Home (AFH) Pilot: Strengths, Abilities, Interests, Learn (SAIL) (Developmental Disabilities Administration) | ||
| 10-688 | DDA Specialty Adult Family Home (AFH) Pilot Monthly Client Goal and Progress Report (Developmental Disabilities Administration) | ||
| 10-689 | Assisted Living Facility Monitoring Visit (Residential Care Services) | ||
| 10-690 | Nursing Care Consultant Transition Tool (Developmental Disabilities Administration) | ||
| 10-691 | Certified Community Residential Services and Supports (CCRSS) Client Characteristics (Residential Care Services) | ||
| 10-692 | Group Training Home (GTH) Team Coordinator (TC) Packet (Residential Care Services) | ||
| 10-693 | Group Training Home (GTH) Client Sample Packet (Residential Care Services) | ||
| 10-695 | Adult Family Home (AFH) Initial Inspection Preparation Checklist (Residential Care Services) | ||
| 10-696 | Assisted Living Facility Medication Observation Worksheet (Residential Care Services) | ||
| 10-697 | Emergency Transitional Support Services Certification Evaluation (Developmental Disabilities Administration) | ||
| 10-698 | Certified Community Residential Services and Supports (CCRSS) Certification Evaluation Administrator Record Review and Interview (Residential Care Services) | ||
| 10-699 | Certified Community Residential Services and Supports (CCRSS) Certification Evaluation Exit Preparation / Exit Conference (Residential Care Services) | ||
| 10-700 | CCRSS Follow-Up Visit (Certified Community Residential Services and Supports, Residential Care Services.) | ||
| 10-701 | Enhanced Respite Services School Notification (Developmental Disabilities Administration) | ||
| 10-705 | Lake Burien Transitional Facility Specialized Treatment Referral | ||
| 10-706 | Lake Burien Transitional Care Facility Dedicated Review Committee (DRC) Determination (Developmental Disabilities Administration) | ||
| 10-707 | Residential Habilitation for Dependent Youth (RHDY) Engagement Plan (Developmental Disabilities Administration) | ||
| 10-708 | Planning for Youth Aged 18-21 Receiving RHDY Services (Developmental Disabilities Administration) | ||
| 10-709 | Request for Residential Habilitation for Dependent Youth Services (Developmental Disabilities Administration) | ||
| 10-711 | Adult Family Homes Program Training Plan (Residential Care Services) |
