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
05-260 Change of Address for an Existing DVIT Certification (Domestic Violence Intervention Treatment)
05-261 Add, Change, or Remove Direct Service Staff for a Certified DVIT Program (Domestic Violence Intervention Treatment)
05-262 Add or Remove a Service for an Existing DVIT Certification (Domestic Violence Intervention Treatment)
05-272 Case Manager Instructions Following a Hearing Decision
05-277 Companion Home DCYF Weekly Schedule (Developmental Disability Administration)
06-123 Nursing Assistant Training and Testing Reimbursement
06-124 Cost of Care Adjustment (COCA) (Developmental Disabilities)
06-125 Residential Allowance Request / Insufficient Income (Developmental Disabilities Administration)
06-125A Residential Allowance Request - Start Up Costs (Developmental Disabilities Administration)
06-125B Residential Allowance Request - Damages (Developmental Disabilities Administration)