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
02-709 Adult Family Home (AFH) Personnel Changes (Residential Care Services)
02-714 Community Instructors Virtual Classroom Training Application (Home and Community Services)
02-716 Rapid Response Team 2 Request (Residential Care Services) (Aging and Long-Term Support Administration)
02-740 Private Duty Nursing (PDN) Time Log for the Month of (Home and Community Services)
02-743 Community Instructor Training Report (Home and Community Services)
02-744 DSHS Remote Skills Training Application: Virtual Classroom (Home and Community Services)
02-751 Accommodations / Modifications Request
02-753 Facility Virtual Classroom Training Application and Attestation (Home and Community Services)
02-754 High School Home Care Aide Student Evaluation Summary Report (Home and Community Services)
02-755 High School Home Care Aide Student Class Evaluation (Home and Community Services)