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
10-326A Staffed Residential Home DCYF Billing
10-328 Residential Site Approval Request
10-329 Informed Consent for ICAP
10-329A Information about the Adaptive Behavior Assessment System (ABAS) for Respondents (Developmental Disabilities Administration)
10-331 DDA Mortality Review Provider Report (Developmental Disabilities Administration)
10-334 Monitoring of Side Effects Scale (MOSES) (DDA)
10-337 Important Information for SSP Recipients and Their Payees (DDA)
10-339 Nursing Care Consultant (NCC) Assessment (Developmental Disabilities Community Services (DDCS))
10-348 Risk Assessment and Community Protection Program Information Checklist
10-349 Comprehensive Regional Review Tool