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
16-284 Pre-Occupancy Inspection Checklist (NH Administrator Use) (Residential Care Services)
16-285 RCS Nursing Home Pre-Occupancy Inspection Site Visit – Initial Findings (Residential Care Services)
16-286 RCS Nursing Home Pre-Occupancy Inspection Follow-Up Site Visit (Residential Care Services)
16-287 Pre-Occupancy Inspection Checklist (Surveyor Use) (Residential Care Services)
16-288 Pre-Occupancy Worksheet: Resident Room / Bathroom (Residential Care Services)
16-289 DSHS New School District Notification following Mutual Acceptance into RHDY (Residential Habilitation for Dependent Youth)
16-302 Residency Agreement Language (Home and Community Living Administration)
16-303 Recommended Diversion Plan (Office of Forensic Mental Health)
16-343 Student Status Confirmation
16-345 Health Related Social Needs (HRSN) Home Accessibility