Caregiver Forms

Below are downloadable forms and resources you will need as a licensed caregiver in Washington State including some DSHS forms which have been approved to be available for public use.  These forms are available for electronic completion in different software; however, all forms below are available as Adobe Acrobat PDF files. This means you can open, view, and print each form. To open, view, and print PDF forms, you need to download the free Adobe Acrobat Reader.
 
If you do not have Microsoft Word, download Microsoft Viewer. This allows you to open, view, and print Word forms. If asked for a password when using Microsoft Word forms, select the cancel button to continue. Passwords prevent changes being made to the form's content.
 
We do our best to ensure the links below are accurate; but, if you find a link which does not work, please contact Kathleen-Haugland@olivecrest.org.

 

A  B  C  D  E  F G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z


A

Acronyms and Definitions
Application for Respite Provider Approval (#14-512)
Asthma Health Care Tips

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C

Caregiver's Report to the Court
CHET (Child Well-Being Health and Education Tracking) Information Sheet
Child Information/Placement Referral (DSHS 15-300)
Child Restraints Information Sheet

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D

Dental Care Tips
Direct Deposit Payment Authorization Form
Direct Deposit Payment Brochure
Direct Deposit Payment Information Sheet
DSHS Initial Placement Letter

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E

Education Advocacy Guide for Caregivers
Educational Resources for Youth in Foster Care
Employed Foster Parent Child Care Plan (#10-406)          English          Spanish
EPSDT (Early and Periodic Screening Diagnosis and Treatment)

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F

Family Home Study Application (#10-354)          English          Spanish
Financial Worksheet (#14-452)
Fire Evacuation Plan (#16-204)          English          Spanish
First 30 Days of Placement Checklist
Foster Home Inspection Checklist (#10-183)          English          Spanish
Foster Parent Reimbursement Claim Checklist and Form
Foster Parents Rights and Responsibilities

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G

Guidelines for Foster Child Activities

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H

Head Lice Brochure
Head Lice Information Sheet
Household Safety Inspection for Unlicensed Relatives/Suitable Others (#10-453)

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I

Initial Health Evaluation Form (72 hours)
Invoice Express Information

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L

Licensing WACs

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M

Mandatory Reporting Guidelines
Marital/Civil Union/Domestic Partnership History (#09-979)
Medical WACs
Mileage Calculation Form
Monthly Mileage Form

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P

Personal Information (#15-276)          English          Spanish
Policy Agreements (#10-290)          English          Spanish
Policy Statement- Youth Missing from Care

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R

Rate Assessment Guide for Foster Parents
Reference Questionnaire (#15-286)          English          Spanish
Release of Information (ROI) Form
Respite Care Provider Cover Letter (#14-513)
Respite Provider Checklist (#16-225)
Respite Provider Policy Agreement (#14-510)
Respite Request & Billing for Region 2

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S

Social Network Guidelines
SSPS Invoice Instructions (DSHS 08-141) 

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T

Third Party Claim Checklist and Form (DSHS 18-400A)
Travel Policy for Caregivers (August 2012)

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V

Voucher for Interim Pharmacy and Medical Services for Foster Children

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W

WACs (Licensing Requirements for Foster Homes)          English          Spanish

 

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