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1709
![DSHS Form 06-124 "Cost of Care Adjustment (Coca)" - Washington](https://data.templateroller.com/pdf_docs_html/2036/20367/2036737/dshs-form-06-124-cost-of-care-adjustment-coca-washington.png "DSHS Form 06-124 "Cost of Care Adjustment (Coca)" - Washington")
DSHS Form 06-124 "Cost of Care Adjustment (Coca)" - Washington
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(4.3 / 5) 11 votes Size: 38 KB
1
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![DSHS Form 14-012 "Consent" - Washington (Haitian Creole)](https://data.templateroller.com/pdf_docs_html/2036/20367/2036784/dshs-form-14-012-consent-washington-haitian-creole.png "DSHS Form 14-012 "Consent" - Washington (Haitian Creole)")
DSHS Form 14-012 "Consent" - Washington (Haitian Creole)
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(4.8 / 5) 25 votes Size: 38 KB
4
pages
![DSHS Form 17-063 "Authorization" - Washington (Lao)](https://data.templateroller.com/pdf_docs_html/2036/20368/2036831/dshs-form-17-063-authorization-washington-lao.png "DSHS Form 17-063 "Authorization" - Washington (Lao)")
![DSHS Form 14-012 "Consent" - Washington (Mien)](https://data.templateroller.com/pdf_docs_html/2036/20367/2036789/dshs-form-14-012-consent-washington-mien.png "DSHS Form 14-012 "Consent" - Washington (Mien)")
![DSHS Form 17-063 "Authorization" - Washington (Somali)](https://data.templateroller.com/pdf_docs_html/2036/20368/2036833/dshs-form-17-063-authorization-washington-somali.png "DSHS Form 17-063 "Authorization" - Washington (Somali)")
![DSHS Form 14-012 "Consent" - Washington (English/Hindi)](https://data.templateroller.com/pdf_docs_html/2036/20367/2036786/dshs-form-14-012-consent-washington-english-hindi.png "DSHS Form 14-012 "Consent" - Washington (English/Hindi)")
DSHS Form 14-012 "Consent" - Washington (English/Hindi)
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(4.4 / 5) 11 votes Size: 249 KB
3
pages
![DSHS Formulario 17-041 "Solicitud De Registros Del Dshs" - Washington (Spanish)](https://data.templateroller.com/pdf_docs_html/2036/20368/2036834/dshs-formulario-17-041-solicitud-de-registros-del-dshs-washington-spanish.png "DSHS Formulario 17-041 "Solicitud De Registros Del Dshs" - Washington (Spanish)")
DSHS Formulario 17-041 "Solicitud De Registros Del Dshs" - Washington (Spanish)
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(4.4 / 5) 8 votes Size: 50 KB
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![DSHS Form 14-012 "Consent" - Washington (French)](https://data.templateroller.com/pdf_docs_html/2036/20367/2036785/dshs-form-14-012-consent-washington-french.png "DSHS Form 14-012 "Consent" - Washington (French)")
![DSHS Form 14-012 "Consent" - Washington (Ilocano)](https://data.templateroller.com/pdf_docs_html/2036/20367/2036787/dshs-form-14-012-consent-washington-ilocano.png "DSHS Form 14-012 "Consent" - Washington (Ilocano)")
![DSHS Form 14-012 "Consent" - Washington (Oromo)](https://data.templateroller.com/pdf_docs_html/2036/20367/2036788/dshs-form-14-012-consent-washington-oromo.png "DSHS Form 14-012 "Consent" - Washington (Oromo)")
![DSHS Formulario 17-063 "Autorizacion" - Washington (Spanish)](https://data.templateroller.com/pdf_docs_html/2036/20368/2036832/dshs-formulario-17-063-autorizacion-washington-spanish.png "DSHS Formulario 17-063 "Autorizacion" - Washington (Spanish)")
DSHS Formulario 17-063 "Autorizacion" - Washington (Spanish)
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(4.8 / 5) 21 votes Size: 173 KB
2
pages
![DSHS Form 14-012 "Consent" - Washington (Rwanda)](https://data.templateroller.com/pdf_docs_html/2036/20367/2036792/dshs-form-14-012-consent-washington-rwanda.png "DSHS Form 14-012 "Consent" - Washington (Rwanda)")
![DSHS Form 15-344 "Private Duty Nursing Logs and Skilled Nursing Tasks Log" - Washington](https://data.templateroller.com/pdf_docs_html/2036/20368/2036808/dshs-form-15-344-private-duty-nursing-logs-and-skilled-nursing-tasks-log-washington.png "DSHS Form 15-344 "Private Duty Nursing Logs and Skilled Nursing Tasks Log" - Washington")
DSHS Form 15-344 "Private Duty Nursing Logs and Skilled Nursing Tasks Log" - Washington
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(4.4 / 5) 22 votes Size: 72 KB
1
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![DSHS Form 17-041 "Request for DSHS Records" - Washington (Chinese)](https://data.templateroller.com/pdf_docs_html/2036/20368/2036828/dshs-form-17-041-request-for-dshs-records-washington-chinese.png "DSHS Form 17-041 "Request for DSHS Records" - Washington (Chinese)")
DSHS Form 17-041 "Request for DSHS Records" - Washington (Chinese)
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(4.6 / 5) 7 votes Size: 199 KB
1
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![DSHS Form 14-012 "Consent" - Washington (Gujarati)](https://data.templateroller.com/pdf_docs_html/2036/20367/2036791/dshs-form-14-012-consent-washington-gujarati.png "DSHS Form 14-012 "Consent" - Washington (Gujarati)")
![DSHS Form 10-646 "Residential Evaluation Family / Legal Representative / Collateral Relationships Interview" - Washington](https://data.templateroller.com/pdf_docs_html/2036/20367/2036768/dshs-form-10-646-residential-evaluation-family-legal-representative-collateral-relationships-interview-washington.png "DSHS Form 10-646 "Residential Evaluation Family / Legal Representative / Collateral Relationships Interview" - Washington")
DSHS Form 10-646 "Residential Evaluation Family / Legal Representative / Collateral Relationships Interview" - Washington
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(4.3 / 5) 30 votes Size: 49 KB
1
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![DSHS Form 10-644 "Home and Community-Based Services (Hcbs) Waiver Approval Notification" - Washington (Chinese)](https://data.templateroller.com/pdf_docs_html/2036/20367/2036764/dshs-form-10-644-home-and-community-based-services-hcbs-waiver-approval-notification-washington-chinese.png "DSHS Form 10-644 "Home and Community-Based Services (Hcbs) Waiver Approval Notification" - Washington (Chinese)")
DSHS Form 10-644 "Home and Community-Based Services (Hcbs) Waiver Approval Notification" - Washington (Chinese)
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(4.8 / 5) 8 votes Size: 195 KB
1
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![DSHS Form 17-041 "Request for DSHS Records" - Washington (Cambodian)](https://data.templateroller.com/pdf_docs_html/2036/20368/2036827/dshs-form-17-041-request-for-dshs-records-washington-cambodian.png "DSHS Form 17-041 "Request for DSHS Records" - Washington (Cambodian)")
DSHS Form 17-041 "Request for DSHS Records" - Washington (Cambodian)
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(4.5 / 5) 11 votes Size: 181 KB
1
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![DSHS Form 14-012 "Consent" - Washington (Tigrigna)](https://data.templateroller.com/pdf_docs_html/2036/20367/2036794/dshs-form-14-012-consent-washington-tigrigna.png "DSHS Form 14-012 "Consent" - Washington (Tigrigna)")
![DSHS Form 10-644 "Home and Community-Based Services (Hcbs) Waiver Approval Notification" - Washington (Russian)](https://data.templateroller.com/pdf_docs_html/2036/20367/2036769/dshs-form-10-644-home-and-community-based-services-hcbs-waiver-approval-notification-washington-russian.png "DSHS Form 10-644 "Home and Community-Based Services (Hcbs) Waiver Approval Notification" - Washington (Russian)")
DSHS Form 10-644 "Home and Community-Based Services (Hcbs) Waiver Approval Notification" - Washington (Russian)
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(4.3 / 5) 8 votes Size: 200 KB
1
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![DSHS Form 17-041 "Request for DSHS Records" - Washington (Russian)](https://data.templateroller.com/pdf_docs_html/2036/20368/2036830/dshs-form-17-041-request-for-dshs-records-washington-russian.png "DSHS Form 17-041 "Request for DSHS Records" - Washington (Russian)")
DSHS Form 17-041 "Request for DSHS Records" - Washington (Russian)
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(4.3 / 5) 23 votes Size: 200 KB
1
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![DSHS Form 14-012 "Consent" - Washington (Fijian)](https://data.templateroller.com/pdf_docs_html/2036/20367/2036783/dshs-form-14-012-consent-washington-fijian.png "DSHS Form 14-012 "Consent" - Washington (Fijian)")
![DSHS Form 14-012 "Consent" - Washington (Albanian)](https://data.templateroller.com/pdf_docs_html/2036/20367/2036781/dshs-form-14-012-consent-washington-albanian.png "DSHS Form 14-012 "Consent" - Washington (Albanian)")
![DSHS Form 10-643 "Request for Skilled Nursing in a Community Setting (Pre-admission Screening and Resident Review)" - Washington](https://data.templateroller.com/pdf_docs_html/2036/20367/2036765/dshs-form-10-643-request-for-skilled-nursing-in-a-community-setting-pre-admission-screening-and-resident-review-washington.png "DSHS Form 10-643 "Request for Skilled Nursing in a Community Setting (Pre-admission Screening and Resident Review)" - Washington")
DSHS Form 10-643 "Request for Skilled Nursing in a Community Setting (Pre-admission Screening and Resident Review)" - Washington
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(4.6 / 5) 25 votes Size: 60 KB
2
pages
![DSHS Form 14-012 "Consent" - Washington (Turkish)](https://data.templateroller.com/pdf_docs_html/2036/20367/2036793/dshs-form-14-012-consent-washington-turkish.png "DSHS Form 14-012 "Consent" - Washington (Turkish)")
![DSHS Form 10-644 "Home and Community-Based Services (Hcbs) Waiver Approval Notification" - Washington (Korean)](https://data.templateroller.com/pdf_docs_html/2036/20367/2036766/dshs-form-10-644-home-and-community-based-services-hcbs-waiver-approval-notification-washington-korean.png "DSHS Form 10-644 "Home and Community-Based Services (Hcbs) Waiver Approval Notification" - Washington (Korean)")
DSHS Form 10-644 "Home and Community-Based Services (Hcbs) Waiver Approval Notification" - Washington (Korean)
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(4.7 / 5) 19 votes Size: 231 KB
1
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![DSHS Form 10-613 Attachment C "Ccrss Certification Evaluation Client Observation" - Washington](https://data.templateroller.com/pdf_docs_html/2036/20367/2036761/dshs-form-10-613-attachment-c-ccrss-certification-evaluation-client-observation-washington.png "DSHS Form 10-613 Attachment C "Ccrss Certification Evaluation Client Observation" - Washington")
DSHS Form 10-613 Attachment C "Ccrss Certification Evaluation Client Observation" - Washington
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(4.3 / 5) 15 votes Size: 64 KB
3
pages
![DSHS Form 02-690 "Student Evaluation Summary Report" - Washington](https://data.templateroller.com/pdf_docs_html/2036/20367/2036726/dshs-form-02-690-student-evaluation-summary-report-washington.png "DSHS Form 02-690 "Student Evaluation Summary Report" - Washington")
DSHS Form 02-690 "Student Evaluation Summary Report" - Washington
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(4.8 / 5) 6 votes Size: 33 KB
2
pages
![DSHS Form 02-691 "Student Class Evaluation" - Washington](https://data.templateroller.com/pdf_docs_html/2036/20367/2036727/dshs-form-02-691-student-class-evaluation-washington.png "DSHS Form 02-691 "Student Class Evaluation" - Washington")
![DSHS Form 10-582 "Notification of Age Nineteen (19) Eligibility Review" - Washington](https://data.templateroller.com/pdf_docs_html/2036/20367/2036760/dshs-form-10-582-notification-of-age-nineteen-19-eligibility-review-washington.png "DSHS Form 10-582 "Notification of Age Nineteen (19) Eligibility Review" - Washington")
DSHS Form 10-582 "Notification of Age Nineteen (19) Eligibility Review" - Washington
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(4.7 / 5) 23 votes Size: 35 KB
2
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![DSHS Form 15-435 "Documentation of Esit Eligibility for Dda" - Washington](https://data.templateroller.com/pdf_docs_html/2036/20368/2036812/dshs-form-15-435-documentation-of-esit-eligibility-for-dda-washington.png "DSHS Form 15-435 "Documentation of Esit Eligibility for Dda" - Washington")
DSHS Form 15-435 "Documentation of Esit Eligibility for Dda" - Washington
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(4.7 / 5) 14 votes Size: 24 KB
1
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![DSHS Form 17-278 "Pasrr Equipment Purchase Request" - Washington](https://data.templateroller.com/pdf_docs_html/2036/20368/2036836/dshs-form-17-278-pasrr-equipment-purchase-request-washington.png "DSHS Form 17-278 "Pasrr Equipment Purchase Request" - Washington")
DSHS Form 17-278 "Pasrr Equipment Purchase Request" - Washington
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(4.4 / 5) 17 votes Size: 54 KB
2
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![DSHS Form 10-377 "Notification of Age Four (4) Eligibility Expiration" - Washington (Tamil)](https://data.templateroller.com/pdf_docs_html/2036/20367/2036753/dshs-form-10-377-notification-of-age-four-4-eligibility-expiration-washington-tamil.png "DSHS Form 10-377 "Notification of Age Four (4) Eligibility Expiration" - Washington (Tamil)")
DSHS Form 10-377 "Notification of Age Four (4) Eligibility Expiration" - Washington (Tamil)
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(4.3 / 5) 12 votes Size: 1 MB
5
pages
![DSHS Form 10-377 "Notification of Age Four (4) Eligibility Expiration" - Washington (French)](https://data.templateroller.com/pdf_docs_html/2036/20367/2036750/dshs-form-10-377-notification-of-age-four-4-eligibility-expiration-washington-french.png "DSHS Form 10-377 "Notification of Age Four (4) Eligibility Expiration" - Washington (French)")
DSHS Form 10-377 "Notification of Age Four (4) Eligibility Expiration" - Washington (French)
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(4.8 / 5) 10 votes Size: 1 MB
2
pages
![DSHS Form 10-377 "Notification of Age Four (4) Eligibility Expiration" - Washington](https://data.templateroller.com/pdf_docs_html/2036/20367/2036749/dshs-form-10-377-notification-of-age-four-4-eligibility-expiration-washington.png "DSHS Form 10-377 "Notification of Age Four (4) Eligibility Expiration" - Washington")
DSHS Form 10-377 "Notification of Age Four (4) Eligibility Expiration" - Washington
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(4.7 / 5) 33 votes Size: 36 KB
2
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![DSHS Form 14-473 "Inventory for Client and Agency Planning (Icap) Letter" - Washington](https://data.templateroller.com/pdf_docs_html/2036/20367/2036799/dshs-form-14-473-inventory-for-client-and-agency-planning-icap-letter-washington.png "DSHS Form 14-473 "Inventory for Client and Agency Planning (Icap) Letter" - Washington")
DSHS Form 14-473 "Inventory for Client and Agency Planning (Icap) Letter" - Washington
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(4.3 / 5) 6 votes Size: 30 KB
1
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![DSHS Form 15-291 "Person Centered Service Planning and Annual Assessment Meeting" - Washington (English/Lao)](https://data.templateroller.com/pdf_docs_html/2036/20368/2036805/dshs-form-15-291-person-centered-service-planning-and-annual-assessment-meeting-washington-english-lao.png "DSHS Form 15-291 "Person Centered Service Planning and Annual Assessment Meeting" - Washington (English/Lao)")
DSHS Form 15-291 "Person Centered Service Planning and Annual Assessment Meeting" - Washington (English/Lao)
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(4.8 / 5) 18 votes Size: 187 KB
2
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![DSHS Form 15-314 "Client Necessary Supplemental Accommodation Representative Requirement Checklist" - Washington](https://data.templateroller.com/pdf_docs_html/2036/20368/2036807/dshs-form-15-314-client-necessary-supplemental-accommodation-representative-requirement-checklist-washington.png "DSHS Form 15-314 "Client Necessary Supplemental Accommodation Representative Requirement Checklist" - Washington")
DSHS Form 15-314 "Client Necessary Supplemental Accommodation Representative Requirement Checklist" - Washington
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(4.3 / 5) 16 votes Size: 26 KB
1
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![DSHS Form 16-230 "Children's Residential Services Contractor File Checklist" - Washington](https://data.templateroller.com/pdf_docs_html/2036/20368/2036826/dshs-form-16-230-children-s-residential-services-contractor-file-checklist-washington.png "DSHS Form 16-230 "Children's Residential Services Contractor File Checklist" - Washington")
DSHS Form 16-230 "Children's Residential Services Contractor File Checklist" - Washington
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(4.7 / 5) 11 votes Size: 25 KB
1
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![DSHS Form 10-377 "Notification of Age Four (4) Eligibility Expiration" - Washington (Hindi)](https://data.templateroller.com/pdf_docs_html/2036/20367/2036756/dshs-form-10-377-notification-of-age-four-4-eligibility-expiration-washington-hindi.png "DSHS Form 10-377 "Notification of Age Four (4) Eligibility Expiration" - Washington (Hindi)")
DSHS Form 10-377 "Notification of Age Four (4) Eligibility Expiration" - Washington (Hindi)
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(4.6 / 5) 11 votes Size: 1 MB
2
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