Washington Dshs Medical Forms

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Electronic DSHS Forms | DSHS - Washington

https://www.dshs.wa.gov/office-of-the-secretary/forms

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 …

Food, Cash, Medical | DSHS - Washington

https://www.dshs.wa.gov/food-cash-medical

Am I eligible for food, cash, or medical assistance? Find out if you have unclaimed property such as bank accounts, uncashed checks, insurance payouts, and more How do I report …

How to Apply for Medicaid | DSHS - Washington

https://www.dshs.wa.gov/altsa/home-and-community-services/how-apply-medicaid

Washington Apple Health Application for Long-term Care/Aged, Blind, Disabled Coverage Form (Form 18-005) Apply on-line All Washington residents can apply for Health Care …

Forms you might need | DSHS - Washington

https://www.dshs.wa.gov/esa/forms-you-might-need

You may call the Child Care Subsidy Contact Center at 1-844-626-8687 to request a form. Mail the complete application form to DCYF, PO Box 11346, Tacoma, WA 98411-9903, …

Forms | DSHS - Washington

https://www.dshs.wa.gov/node/30892

Caregiving Experience Attestation (CEA) Form (DSHS 10-417) Disclosure of Charges Form Word / PDF (DSHS 15-449) Disclosure of Services Form Word / PDF (DSHS 10-508) …

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

HCA and DSHS WACs and rulemaking links. Title 388 of Washington Administrative Code (WAC) Department of Social & Health Services (DSHS) Code …

Washington State Department of Social and Health …

https://www.dshs.wa.gov/

Adult Care. Mental Health & Addiction Services. Disability Support. ESA Economic Services Administration. OS Office of the Secretary. FFA Facilities, Finance and Analytics Administration. DVR Division of …

Filing an Application | DSHS - Washington

https://www.dshs.wa.gov/esa/applications-assistance/filing-application

Review form DSHS 14-113(X), Client Rights and Responsibilities with the household: Face to Face Interviews; When conducting a face-to-face interview, explain the rights and …

Forms and publications | Washington State Health Care …

https://www.hca.wa.gov/free-or-low-cost-health-care/forms-and-publications

12-506 Form Administrative hearing rights and deadlines - DSHS Classic Medicaid This document provides information on your rights and the deadlines associated with …

18-682 Detail Sheet - Uninsured Health Care …

https://www.dshs.wa.gov/sites/default/files/ESA/dcs/documents/18-682.pdf

Use a separate Detail Sheet for each parent from whom you are requesting reimbursement. List the expenses of all of that parent's children on the form. List the health insurance …

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