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
18-555 Financial Information Sheet
18-607 Child Care Verification
18-681 Request for Collection of Uninsured Health Care Expenses
18-682 Detail Sheet – Uninsured Health Care Expenses
18-700 Direct Deposit Authorization
18-701 Request for Income Information for Purposes of Entering or Enforcing a Child Support Order
18-720 Client Responsibility Notice (Home and Community Services)
18-739 Pre-Acquisition Disclosure (Division of Child Support)
19-074 Transfer / Loan / Recovery Agreement (Division of Vocational Rehabilitation)
19-237 Application Budget Summary (Residential Care Services)