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
27-179 Adult Family Home (AFH) Informal Dispute Resolution (IDR) Request (Residential Care Services)
27-182 DSHS Request for Positive Identification – Thumbprint
27-188 Initial Opiate Prescription Informed Consent (Behavioral Health Administration)
27-189 Asset Verification Authorization (Home and Community Services)
27-207 Acknowledgement Statement (Meaningful Day) (Home and Community Services)
27-208 Declaration to Adult Protective Services
27-209 Nursing Home Informal Dispute Resolution Request (Residential Care Services)
27-210 DDA Authorization for Release of Referral Video (Developmental Disabilities Administration)
27-215 Teleservice Agreement (Developmental Disabilities Administration)
27-218 Death Notification Checklist for Residential Habilitation Center (RHC) Staff (Developmental Disabilities Administration)