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This document is used for the incapacity review process related to medical care services in the State of Washington. It outlines the necessary steps and information required for clients under the
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Obtain the DSHS 14-525 MS form from the appropriate department or online.
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Read the instructions provided with the form carefully before starting.
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Fill out your personal information in the designated sections, including your name, address, and contact details.
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Provide information about your household members, including names and relationships.
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Who needs dshs 14-525 ms?

01
Individuals or families seeking assistance from the Department of Social and Health Services (DSHS) in Washington State.
02
Those applying for public benefit programs such as food assistance, medical assistance, or cash assistance.
03
Residents of Washington State who require financial support due to low income or other qualifying factors.
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DSHS 14-525 MS is a form used by the Washington State Department of Social and Health Services to report certain medical assistance information.
Individuals or organizations that provide medical services and bill the state for medical assistance may be required to file the DSHS 14-525 MS form.
To fill out the DSHS 14-525 MS, you need to enter the required information including provider details, the services rendered, and any other relevant billing information as specified in the form's instructions.
The purpose of the DSHS 14-525 MS is to collect necessary data for processing claims for medical assistance and ensuring compliance with state regulations.
The information that must be reported on the DSHS 14-525 MS includes provider identifiers, patient information, services provided, dates of services, and billing amounts.
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Washington Department of Social and Health Services Incapacity Review Medical Care Services Client Information Form DSHS 14-525 MS Psychological Assessment Health Services Client Eligibility Community Service

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