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Dshs authorization form

Dshs 17 063 2025

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The document is an authorization form for disclosing confidential records held by the Department of Social and Health Services (DSHS). It allows individuals to grant permission for specific DSHS programs to share their personal information with designated recipients. The form includes sections for identifying the individual whose records are being disclosed, the recipient of the information, and the specific records to be shared. It also outlines the validity period of the authorization, conditions for revocation, and legal notices regarding sensitive information such as HIV/AIDS and mental health records.

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Who is the head of the DSHS in Washington state?

Meet Our Leadership Cheryl Strange Acting Secretary of DSHS Lisa Yanagida Chief of Staff Amber Leaders Special Assistant to the Secretary Soumam Debgupta Chief Technology Information Officer and Assistant Secretary Technology Innovation6 more rows

How to apply for DSHS benefits in Washington?

You may complete an online application by using the WashingtonConnection.org website, applying by phone at 877-501-2233 or going to your local Community Services Office. On WashingtonConnection.org you can: Start a new application. Report a change, such as address, income or family situation.

Who is the head of the Washington State Department of Transportation?

Incoming Washington State Governor Bob Ferguson (D) has appointed Julie Meredith (above) to be secretary of the Washington State Department of Transportation effective January 15. She replaces Roger Millar, who is stepping down after serving as WSDOT secretary for nine years.

Who is the head of DCYF in Washington state?

Governor-elect Ferguson Announces New Department of Children, Youth, and Families Director. State Representative Tana Senn (D-Mercer Island) will serve as the next Director for the Department of Children, Youth, and Families (DCYF). The mission of DCYF is to ensure that all Washington youth grow up safe and healthy.

Who is the head of the HCA in Washington state?

Email MaryAnne. Appointed by Governor Ferguson in January 2025, MaryAnne Lindeblad serves as HCAs interim director, bringing decades of leadership and expertise to Washingtons largest health care purchaser.

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 phone number for DSHS food stamps in Washington state?

Services are available at your local Community Services Office and by phone through the Customer Service Contact Center at 877-501-2233: TTY/TDD users dial 1-800-833-6384 for Washington Relay Service. Complete interviews for cash or food (application/eligibility review/mid-certification review).

Who is the head of the DNR in Washington state?

Managed by Commissioner Dave Upthegrove, DNR oversees 5.6M acres of state lands.

Dshs 17 063 2025

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Who is the head of the DSHS in Washington state?

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Dshs 17 063 2025

Here's how it works

How to edit Dshs 17 063 online

See more dshs 17 063 versions

Complete this form in 5 minutes or less

Got questions?

Who is the head of the DSHS in Washington state?

How to apply for DSHS benefits in Washington?

Who is the head of the Washington State Department of Transportation?

Who is the head of DCYF in Washington state?

Who is the head of the HCA in Washington state?

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People also ask

What is the DSHS stop work form for Washington state?

What is the phone number for DSHS food stamps in Washington state?

Who is the head of the DNR in Washington state?

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