Forms you might need DSHS 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the CLIENT IDENTIFICATION section. Enter your NAME, DATE OF BIRTH, ADDRESS, IDENTIFICATION NUMBER, CITY, STATE, ZIP CODE, and TELEPHONE NUMBER. Ensure all information is accurate for proper identification.
3. In the CONSENT section, indicate your agreement to share confidential information by checking the appropriate boxes for agencies and individuals listed. Be sure to include their names and addresses as required.
4. Specify which records you authorize for sharing by checking all applicable boxes under 'I authorize and consent to sharing the following records and information.' This includes options like health care information and treatment plans.
5. Complete the duration of consent by selecting either 'one year' or specifying a date/event. Remember that you can revoke this consent at any time in writing.
6. Finally, ensure all signatures are obtained: your signature, date, and if applicable, a parent or representative’s signature along with their contact details.

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