This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington.
The document is provided in Korean. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is DSHS Form 14-341?
A: DSHS Form 14-341 is a Medical/Dental Services Authorization form in Washington state.
Q: What is the purpose of DSHS Form 14-341?
A: The purpose of DSHS Form 14-341 is to authorize and request medical and dental services for eligible individuals in Washington.
Q: Who can use DSHS Form 14-341?
A: DSHS Form 14-341 can be used by individuals who are eligible for medical and dental services provided by the Washington State Department of Social and Health Services (DSHS).
Q: Is DSHS Form 14-341 available in languages other than English?
A: Yes, DSHS Form 14-341 is available in multiple languages, including Korean.
Q: What information is required on DSHS Form 14-341?
A: DSHS Form 14-341 requires information such as the applicant's personal details, income information, and medical or dental condition.
Form Details:
Download a printable version of DSHS Form 14-341 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.