Dshs ita form 2026

1. Click ‘Get Form’ to open the dshs ita form in the editor.
2. Begin by entering the client’s name in the designated fields for last, first, and middle initial. Ensure accuracy as this is crucial for identification.
3. Fill in the address section. If the client is homeless or transient, check the appropriate boxes provided.
4. Input the city and Washington county of residence. If applicable, include the Provider One Client ID.
5. Enter the date of birth and social security number carefully to maintain confidentiality and compliance.
6. Select the gender of the client and provide details about their detention, including the name of the Evaluation & Treatment facility and dates of detention and release.
7. Complete the ITA provider information by filling in their name, title, telephone number, and signature before submitting.

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