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This version of the form is not currently in use and is provided for reference only. Download this version of
DSHS Form 10-104B
for the current year.
DSHS Form 10-104B Service Verification / Attendance Record for Alternative Living Providers - Washington
What Is DSHS Form 10-104B?
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 10-104B?A: DSHS Form 10-104B is a Service Verification/Attendance Record for Alternative Living Providers in Washington.
Q: Who needs to fill out DSHS Form 10-104B?A: Alternative Living Providers in Washington need to fill out DSHS Form 10-104B.
Q: What is the purpose of DSHS Form 10-104B?A: The purpose of DSHS Form 10-104B is to document the services provided and the attendance of individuals receiving alternative living services.
Q: Are there any instructions for filling out DSHS Form 10-104B?A: Yes, there are instructions provided on the form itself. It is important to read and follow the instructions carefully when filling out DSHS Form 10-104B.
Form Details:
- Released on August 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 10-104B by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.
