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
15-554 Facility Instructor Application (Home and Community Services)
15-555 Facility Training Program Application and Updates (Home and Community Services)
15-556 Continuing Care Retirement Community (CCRC) Registration Renewal Addendum (Aging and Long-Term Support Administration)
15-557 Behavior Support Consultation and/or Training Request (Home and Community Services)
15-558 Adult Family Home (AFH) Resident Significant Change Assessment Request
15-559 Adult Family Home Referral Request (Developmental Disabilities Administration)
15-564 Residential Quarterly Report for Children's Residential Services (Developmental Disabilities Administration)
15-567 On-the-Job Facility Training Plan Application and Updates (Home and Community Services)
15-568 DDA Alternative Living Provider Orientation (Developmental Disabilities Administration)
15-569 Notice of Termination of Service (Developmental Disabilities Administration)