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Electronic DSHS Forms | DSHS - Washington

    https://www.dshs.wa.gov/office-of-the-secretary/forms
    DSHS forms are available for electronic completion in different software; however, all DSHS forms below are available as Adobe Acrobat PDF files. This means …

Food, Cash, Medical | DSHS - Washington

    https://www.dshs.wa.gov/food-cash-medical
    Basic Food for Legal Immigrants. Temporary Assistance for Needy Families. Refugee Cash Assistance. Unclaimed property. Apple Health for Kids. Apple Health for Adults. Alien …

How to Apply for Medicaid | DSHS - Washington

    https://www.dshs.wa.gov/altsa/home-and-community-services/how-apply-medicaid
    Call or visit your local HCS office to get a Washington Apple Health Application for Long-Term Care/Aged, Blind, Disabled Coverage (18-005). This form can also be downloaded …

Forms | DSHS - Washington

    https://www.dshs.wa.gov/node/30892
    AFH Information Changes Form (DSHS 10-585) Word / PDF AFH Personnel Changes (DSHS 02-709) Caregiving Experience Attestation (CEA) Form (DSHS 10-417) …

Filing an Application | DSHS - Washington

    https://www.dshs.wa.gov/esa/applications-assistance/filing-application
    The applicant or recipient may make the request in writing by checking the appropriate boxes on the 14-001 or 14-078 form and, dating and initialing the form. Use the date the …

Washington State Department of Social …

    https://www.dshs.wa.gov/
    Nearly one out of every four Washington citizens turns to the Department of Social and Health Services' Economic Services Administration for assistance with cash, food, child support, child …

Forms you might need | DSHS - Washington

    https://www.dshs.wa.gov/esa/forms-you-might-need
    This link will take you to the application form for Child Care Subsidy Program. You may call the Child Care Subsidy Contact Center at 1-844-626-8687 to request a form. Mail the …

DSHS and HCA forms, WACs, rule-making, and useful …

    https://www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple-health/dshs-and-hca-forms-wacs-rule-making-and-useful-ltc-links
    Aging and long-term supports intake phone numbers and links. Home and Community Services (HCS) APS, Area Agencies on Aging (AAA) caregiver and provider …

Forms and publications | Washington State Health Care …

    https://www.hca.wa.gov/free-or-low-cost-health-care/forms-and-publications
    Administrative hearing request – HCA/HBE. Use this form to request a hearing before a judge. Mail this form within 90 calendar days of the date on eligibility notice you disagree …

Division of Child Support Forms | DSHS - Washington

    https://www.dshs.wa.gov/esa/division-child-support/division-child-support-forms
    Permission to Share Documents for Reimbursement of Medical Expenses: 27-096, 27-096sp (Spanish) Use this form to serve a Notice of Support Owed – Medical …



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