DSHS Form 12-195 Disqualification Consent Agreement - Washington

DSHS Form 12-195 Disqualification Consent Agreement - Washington

What Is DSHS Form 12-195?

This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2019;
  • The latest edition provided by the Washington State Department of Social and Health Services;
  • Easy to use and ready to print;
  • Available in Cambodian;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of DSHS Form 12-195 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.

ADVERTISEMENT

Other Revision

Download DSHS Form 12-195 Disqualification Consent Agreement - Washington

4.4 of 5 (82 votes)
  • DSHS Form 12-195 Disqualification Consent Agreement - Washington, Page 1
ADVERTISEMENT