Electronic DSHS Forms

The Electronic DSHS Forms page is a centralized repository where the public can find and download official forms for Washington Department of Social and Health Services programs.

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 Form File
02-566 Protected Health Information (PHI) Amendment
02-586 Temporary Employment Hours Tracking Log
02-589 Companion Home Outside Employment Notification and Review (Developmental Disabilities Administration)
02-592 Application for Approval of Interpreter and Translator Continuing Education Activity
02-611 Statement of Understanding: Mid-Certification Review
02-615 Social Services Invoice / Receipt Packet Cover (Home and Community Services)
02-632 Residential Provider's Report of Weapon Ownership in Residential Setting
02-690 Student Evaluation Summary Report
02-691 Student Class Evaluation
02-692 Community Instructor Class List Tracking Log