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
11-067 Monthly Budget Worksheet (Division of Vocational Rehabilitation)
11-068 Customer Internship Program Internship Application (Division of Vocational Rehabilitation)
11-069 DVR Partnership Internship Agreement (Division of Vocational Rehabilitation)
11-070 DVR Attendance Log and Billing Invoice (Division of Vocational Rehabilitation)
11-071 DVR Customer Internship Program Employer Expense Worksheet (Division of Vocational Rehabilitation)
11-084 Contracted Employee(s) to Provide IL Services and Service(s) Approved (Division of Vocational Rehabilitation)
11-088 DVR, DSB, and PIHE Student Accommodation Cost Share Worksheet
11-097 Service Delivery Outcome Report: IL (Independent Living Services) (Division of Vocational Rehabilitation)
11-098 Vocational Assessment Worksheet
11-106 Service Delivery Outcome Plan (SDOP): IL Pre-ETS (Pre-Employment Transition Services) Self-Advocacy Training (Division of Vocational Rehabilitation))