PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
DSHS Form 14-431A
for the current year.
DSHS Form 14-431A Ccss Medical / Dental Services Authorization - Washington
What Is DSHS Form 14-431A?
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 14-431A?
A: DSHS Form 14-431A is a Medical/Dental Services Authorization form in Washington.
Q: What is the purpose of DSHS Form 14-431A?
A: The purpose of DSHS Form 14-431A is to authorize and request medical or dental services for eligible individuals in Washington.
Q: Who can use DSHS Form 14-431A?
A: This form can be used by eligible individuals in Washington who need to access medical or dental services.
Q: How do I fill out DSHS Form 14-431A?
A: To fill out DSHS Form 14-431A, you will need to provide your personal information, the eligible individual's information, information about the requested medical or dental services, and any supporting documentation. Follow the instructions on the form carefully.
Q: Are there any fees associated with DSHS Form 14-431A?
A: No, there are no fees associated with submitting DSHS Form 14-431A.
Q: How long does it take to process DSHS Form 14-431A?
A: The processing time for DSHS Form 14-431A can vary depending on the circumstances. Contact DSHS or your local office for more information.
Q: What if I have questions or need assistance with DSHS Form 14-431A?
A: If you have questions or need assistance with DSHS Form 14-431A, you can contact your local DSHS office or refer to the instructions provided with the form.
Q: Is DSHS Form 14-431A specific to Washington state?
A: Yes, DSHS Form 14-431A is specific to the state of Washington.
Form Details:
- Released on July 1, 2019;
- 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 14-431A by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.
