Washington State Department of Social and Health Services Home page


Background Authorization Form with Instructions: The Background Authorization Form is used by multiple DSHS programs to meet varying background check needs. The instructions provide general directions for completing the Background Check Authorization Form. The DSHS program that is requiring the background check may have additional instructions that you must follow.

For English: Word or PDF

For other languages:  Amharic, Arabic, Burmese, Cambodian, Chinese, Dinka, French, Farsi, Karen, Kayah, Kirundi, Korean, Laotian, Marshallese, NepaliNuerOromo, Polish, Punjabi, Russian, Samoan, Serbo-Croatian, SomaliSpanish, Spanish Word, SwahiliTagalog, Tigrigna, Trukese, Ukrainian, Vietnamese