PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
DSHS Form 11-114
for the current year.
DSHS Form 11-114 Referral Contact Sheet - Washington
What Is DSHS Form 11-114?
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.
FAQ
Q: What is DSHS Form 11-114?A: DSHS Form 11-114 is a Referral Contact Sheet used in Washington.
Q: What is the purpose of DSHS Form 11-114?A: The purpose of DSHS Form 11-114 is to provide contact information for referrals in Washington.
Q: Who uses DSHS Form 11-114?A: DSHS Form 11-114 is used by the Washington Department of Social and Health Services (DSHS) and its partners.
Q: What information is included in DSHS Form 11-114?A: DSHS Form 11-114 includes contact information for the referring organization, the individual being referred, and the person responsible for the referral.
Q: Is DSHS Form 11-114 required for all referrals in Washington?A: It depends on the specific requirements of the referring organization. Some organizations may require the use of DSHS Form 11-114, while others may have their own referral forms.
Form Details:
- Released on March 1, 2016;
- The latest edition provided by the Washington State Department of Social and Health Services;
- Easy to use and ready to print;
- 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 11-114 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.
