WA DSHS 13-678 2016 free printable template

Nurse Delegation: Consent for Delegation Process 1. CLIENT NAME2. DATE OF BIRTH4. CLIENT ADDRESSCITYSTATE6. FACILITY OR PROGRAM CONTACT3. ID/SETTING (OPTIONAL)ZIP CODE5. TELEPHONE NUMBER7. TELEPHONE

How to fill out WA DSHS 13-678

How to fill out WA DSHS 13-678

1. Begin by downloading the WA DSHS 13-678 form from the official Washington DSHS website.
2. Read the instructions provided at the top of the form to understand what information is required.
3. Fill out the personal information section, including your name, address, and contact details.
4. Provide your social security number if applicable and any other identification numbers requested.
5. Complete the section regarding your household information, listing all members living with you.
6. Fill out the section that relates to your income, detailing any sources of income and amounts.
7. Include any additional required information or documents as specified by the form.
8. Review the entire form for accuracy and completeness.
9. Sign and date the form in the designated areas.
10. Submit the completed form as directed, either by mail or electronically if applicable.

Who needs WA DSHS 13-678?

1. Individuals or families applying for public assistance programs in Washington state.
2. Those who are seeking food assistance or other support services through the Washington Department of Social and Health Services (DSHS).
3. People required to report income or household changes to maintain eligibility for assistance.

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What is WA DSHS 13-678?

WA DSHS 13-678 is a specific form used by the Washington State Department of Social and Health Services (DSHS) for reporting and documenting certain information related to social services.

Who is required to file WA DSHS 13-678?

Individuals or organizations that receive services from DSHS or are involved in programs governed by DSHS regulations are typically required to file WA DSHS 13-678.

How to fill out WA DSHS 13-678?

To fill out WA DSHS 13-678, begin by carefully reading the instructions provided with the form. Provide accurate information in the required fields, ensuring that all sections are completed as specified. Once filled out, submit the form according to the guidelines.

What is the purpose of WA DSHS 13-678?

The purpose of WA DSHS 13-678 is to collect necessary information to ensure compliance with state regulations and to facilitate the provision of social services to individuals in Washington State.

What information must be reported on WA DSHS 13-678?

The information that must be reported on WA DSHS 13-678 includes personal identification details, service-related information, any relevant financial data, and other specifics as required by the form.