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WA DSHS 09-966 2003-2026 free printable template

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CHILDREN S ADMINISTRATION AUTHORIZATION TO RELEASE INFORMATION TO THE COURT (PER RCW 13.50.100) AUTHORIZATION TO DISCLOSE RECORDS OF: NAME LAST FIRST The following information may help in locating
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Download the WA DSHS 09-966 form from the official website.
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Read the instructions provided at the top of the form carefully.
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Fill out the personal information section with your name, address, and contact information.
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Provide any relevant identification numbers, such as Social Security Number or case number.
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Complete the sections related to your specific needs or circumstances as required.
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Review your entries for accuracy and completeness before submitting.
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Sign and date the form at the designated area.
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Submit the form via the method specified in the instructions, either by mail or online.

Who needs WA DSHS 09-966?

01
Individuals seeking financial assistance or social services from the Washington Department of Social and Health Services.
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Families in need of support for childcare, medical assistance, or other welfare programs.
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People who are applying for or renewing their benefits from DSHS.
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WA DSHS 09-966 is a form utilized by the Washington State Department of Social and Health Services (DSHS) for reporting various social services and assistance-related information.
Individuals or organizations that are providing social and health services and need to report specific information to the DSHS are required to file WA DSHS 09-966.
To fill out WA DSHS 09-966, you should follow the instructions provided on the form, ensuring that all required sections are completed accurately with relevant information pertaining to the services being reported.
The purpose of WA DSHS 09-966 is to collect essential data regarding social and health services provided, which helps in monitoring, evaluating, and planning for social services in Washington State.
The information that must be reported on WA DSHS 09-966 includes details about the services provided, the demographics of recipients, funding sources, and outcomes of the services rendered.
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