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This form is used for parents or caregivers to request Washington Apple Health benefits for children in tribal foster care in Washington state.
This form is used for requesting Washington Apple Health coverage for children who are aging out of tribal foster care in Washington state.
This form is used for completing a treatment questionnaire in Washington State. It is specifically designed for individuals who speak Russian.
This form is used for attesting to the provision of Applied Behavioral Analysis (ABA) services in Washington.
This form is used for midwives in Washington to attest to their qualifications and credentials. It is a requirement for practicing as a midwife in the state.
This form is used for mental health professionals in Washington to attest their qualifications and comply with state regulations.
This Form is used for registering practitioners and obtaining endorsements in Washington state.
This form is used for nominating a final order to be published in Washington.
This form is used for Washington State PEBB retirees to make changes to their benefits.
This Form is used to attest the capacity of a Applied Behavioral Analysis (ABA) Day Program in Washington.
This form is used for providing general information for authorization in the state of Washington. It is necessary for certain processes or procedures that require authorization by the state.
This form is used for determining the level of support requirement for Applied Behavioral Analysis (ABA) services in Washington state.
This form is used for requesting prior authorization for buprenorphine monotherapy in Washington.
This Form is used for individuals or organizations applying for membership to the Health Technology Clinical Committee in Washington.
This form is used for providing a medical history statement for the School Employees Benefits Board Program in Washington. It is required to provide evidence of insurability for school employees.
This form is used for enrolling in or making changes to long-term disability insurance in the School Employees Benefits Board (SEBB) Program in Washington state.
This Form is used for disenrolling from the Pebb Medicare Advantage Plan in Washington.
This form is used for enrolling in the Pebb Medicare Advantage Plan in Washington.