DSHS Form 27-096 Permission to Share Documents for Reimbursement of Health Care Expenses - Washington

DSHS Form 27-096 Permission to Share Documents for Reimbursement of Health Care Expenses - Washington

What Is DSHS Form 27-096?

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 27-096?A: DSHS Form 27-096 is a permission form that allows the sharing of documents for reimbursement of health care expenses in Washington.

Q: Who needs to use DSHS Form 27-096?A: Individuals who need to be reimbursed for their health care expenses in Washington and want to share their documents with DSHS.

Q: What is the purpose of DSHS Form 27-096?A: The purpose of DSHS Form 27-096 is to give permission to DSHS to access and review an individual's health care documents for the purpose of reimbursing their expenses.

Q: Is DSHS Form 27-096 mandatory?A: No, DSHS Form 27-096 is not mandatory. However, it is required if you want to share your health care documents with DSHS for the purpose of reimbursement.

Q: Do I need to fill out DSHS Form 27-096 for every reimbursement request?A: Yes, you need to fill out DSHS Form 27-096 for every reimbursement request if you want to share your health care documents with DSHS.

Q: Can I revoke permission given through DSHS Form 27-096?A: Yes, you can revoke the permission given through DSHS Form 27-096 at any time by notifying DSHS in writing.

Q: Are there any fees associated with using DSHS Form 27-096?A: No, there are no fees associated with using DSHS Form 27-096. It is a free form provided by DSHS for individuals seeking reimbursement of health care expenses in Washington.

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Form Details:

  • Released on October 1, 2015;
  • The latest edition provided by the Washington State Department of Social and Health Services;
  • Easy to use and ready to print;
  • Available in Spanish;
  • 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 27-096 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.

Download DSHS Form 27-096 Permission to Share Documents for Reimbursement of Health Care Expenses - Washington

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