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
10-7223 State-Operated Community Residential Transitions Program (SOCR-T) Quality Assurance Review
10-723 State-Operated Community Residential Transitions (SOCR-T) Program Certification Evaluation
10-724 Enhanced Respite Services for Children (ERS) Certification Evaluation (Home and Community Living Administration)
10-728 Agency Alternative Living Provider Supplemental Information (Developmental Disabilities Community Services)
10-745 Assisted Living Facilities (ALF) Certified Memory Care Application (Residential Care Services)
11-022 Application for Vocational Rehabilitation Services
11-030 Service Delivery Outcome Report (SDOR) (Division of Vocational Rehabilitation)
11-034B Basic Food Eligibility Requirements: What You Need to Know to Keep Your Benefits
11-058 Trial Work Experience (TWE) Agreement (Division of Vocational Rehabilitation)
11-066 Assistive Communication Technology Request (Office of Deaf and Hard of Hearing)