DBHR Target Detox Short Form - dshs wa 2026

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4.8 out of 5

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The document is a form used by the Division of Behavioral Health and Recovery (DBHR) for client identification and treatment information related to substance use detoxification. It collects personal details such as name, gender, date of birth, race/ethnicity, and social security number, along with treatment specifics including substance use history, referral sources, funding sources, and discharge types.

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Click ‘Get Form’ to open the DBHR Target Detox Short Form in the editor.
Begin by filling out the Client Identification section. Enter the client's last name, first name, middle name, and any other last names. Select the gender and provide the date of birth.
Next, input the Social Security Number and Washington Driver’s License or ID number. For race/ethnicity, check up to four boxes that apply, followed by selecting one option for Spanish/Hispanic/Latino.
Proceed to Treatment Information. Fill in the begin date and time, end date and time, and frequency of use details. Use the provided key codes for substances used.
In the Key Codes section, describe substance use with peak frequency and age of first use. Ensure all fields are completed accurately for effective processing.
Finally, review all entries for accuracy before saving or submitting your form through our platform.

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What is the DSHS stop work form for Washington state?

Stop Work Questionnaire (form 14-438) This form is used when you stop work or self employment. The form should be signed by you but must be completed by your employer. Your employer can also complete this form On-Line.

What is the Workforce Pathways program in Washington state?

The Workforce Pathways Program provides paid public health internship and professional opportunities that promote equitable access to public health careers for individuals serving communities and regions across Washington State.

What is required when terminating an employee in Washington state?

The law does not require employers to give a worker notice before terminating their job. Employers are not required to give warnings or follow any particular steps before terminating an employee.

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Can you email DSHS Washington state?

You may email Jennifer.McDonald@dshs.wa.gov or call (360) 725-1718.

What does DSHS stand for in WA?

Washington State Department of Social and Health Services.

What forms do I need to hire an employee in Washington state?

Legal Requirements for Hiring an Employee in Washington State Step 1: Master Business License. In Washington, the first step in hiring an employee is to properly report your intention to do so on your master business license application. Step 2: I-9 Form. Step 3: W-4 Form. Step 4: Report Hire to DSHS. Step 5: Taxes.