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12640

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This document is used for reporting cases of Shigella infection in the state of Washington.

This Form is used for reporting cases of Salmonella and documenting laboratory results in the state of Washington.

This form is used for requesting an Abo-Ncle examination report in the state of Washington. It is specific to Washington State.

This document is for approved supervisors in Washington state to provide their statement using DOH Form 647-080.

This Form is used for certifying workers involved in the initial or renewal application for decontaminating clandestine drug labs in Washington state.

This type of document is a complaint form for residents of Washington to report issues with healthcare providers or establishments.

This form is used for applying for a new or additional payee for an IME provider account in Washington.

This form is used for reporting complaints of provider fraud in the state of Washington.

This Form is used for reporting the progress of physical medicine treatment in the state of Washington.

This form is used for updating and documenting changes in EMS (Emergency Medical Services) supervisors in the state of Washington.

This Form is used for dental assistants in Washington to apply for the endorsement to perform sealant and fluoride varnish procedures.

This form is used by the parent, legal guardian, or custodian of minor victims in Washington to request compensation for wage loss incurred as a result of the incident.

This form is used for applying for a Master Level Counselor Provider Account in Washington. It is the application for individuals who wish to provide counseling services at the master's level in the state.

This form is used for Washington state manufactured home installers to report their monthly certification tag activity.

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