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Click ‘Get Form’ to open the DSHS Records Request in the editor.
Begin by filling out your personal information in Section A. Include your name, title, organization (if applicable), mailing address, and contact details.
In Section B, check all relevant DSHS programs from which you are requesting records. This helps specify the nature of your request.
Proceed to Section C to provide details about the client whose records you are requesting. Fill in their name, date of birth, and any identification numbers.
Clearly specify the records you need in Section C. You can list limitations on the records requested if necessary.
If applicable, complete Section D for other types of DSHS records you may need, such as licensing or employment records.
Finally, review Section E regarding access to records and sign where indicated. Ensure you understand any fees associated with obtaining copies.
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The agency provides assistance to 2 million people with programs such as the Supplemental Nutritional Assistance Program, Temporary Assistance for Needy Families and the Office of Refugee and Immigrant Assistance.
How do I apply for Washington DSHS benefits?
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.
How do I contact DSHS 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.
What does DSHS stand for in WA?
Washington State Department of Social and Health Services.
What is the income limit for DSHS in Washington state?
Basic Food Eligibility and Benefits Household SizeMonthly Gross Income 3 $4,442 4 $5,358 5 $6,275 6 $7,1927 more rows
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DSHS public records requestDepartment of Human Services NJDepartment of Human Services NJ phone numberWho at DSHS can receive a public records requestWelfare NJ apply onlineDepartment of Human Services Trenton NJNJ Department of Human Services Provider portalNJ Department of Human Services provider phone number
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You may make a public disclosure request to any DSHS office. You should ask to contact the Public Records Coordinator appointed for that office. If you don
It also permits DSHS to charge the data requestor a standard fee for using the Public Use Data File (PUDF). The PUDF contains patient-level information for
Start a new application. Report a change, such as address, income or family situation. Submit an eligibility review for continuing benefits. Ask Do I Qualify?
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