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
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)
10-713 Nursing Care Consultant (NCC) Focused Assessment (Developmental Disabilities Administration)
10-717 Assisted Living Facility Staff Interview - Attachment F (Home and Community Living Administration)
10-718 Integrated Settings Survey Client Interview Adult Family Homes (AFH) / Assisted Living Facilities (ALF) (Developmental Disabilities Community Services (DDCS)
10-719 Integrated Settings Survey Site Contact Interview Adult Family Homes (AFH) / Assisted Living Facilities (ALF) (Developmental Disabilities Community Services (DDCS)
10-720 Certified Children’s Residential Services Initial Application (Developmental Disabilities Administration)
10-721 Children’s Residential Habilitation Services Certification Evaluation (Home and Community Living Administration)
10-722 State-Operated Community Residential Transitions Program (SOCR-T) Certification Evaluation Checklist (Home and Community Living Administration)