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EXHIBIT A Application Checklist (Psychological) Complete and return this form as part of your application packet. APPLICANT ADDS USE ONLY Applicant Name: (please print) Applicant Name: (please print)
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Psychological - DSHS WA refers to the Psychological Evaluation form required by the Washington State Department of Social and Health Services.
Individuals applying for certain services or benefits from the Washington State Department of Social and Health Services may be required to file a Psychological Evaluation.
The Psychological Evaluation form can be filled out by a licensed psychologist or mental health professional who has conducted the evaluation.
The purpose of the Psychological Evaluation form is to assess an individual's mental health and determine their eligibility for certain services or benefits from the Washington State Department of Social and Health Services.
The Psychological Evaluation form typically includes the individual's mental health history, current symptoms, diagnosis, and recommendations for treatment.
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