Get Application For Certification Of A Branch Of A ... - Dshs - Dshs Wa 2017-2025
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How to fill out the application for certification of a branch of a new chemical dependency service provider - DSHS - Dshs Wa online
Completing the application for certification of a branch of a new chemical dependency service provider can be a straightforward process when guided correctly. This guide offers clear, step-by-step instructions to help you successfully fill out the application online.
Follow the steps to complete the application form accurately.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Fill out Part 1 of 2 - Owner/Provider Information. Provide the owner's name and the branch agency name as it appears on your Washington State Master Business License or as the applicable tribal, federal, state, or local authority. Ensure that the name is consistent with official documents.
- Select the chemical dependency services for which you are applying. Mark all applicable services such as detoxification, residential, outpatient treatment, assessment, and information assistance, and provide details like the total number of beds as required.
- Gather and attach required application materials. Ensure you include the $500 application fee (if applicable), copies of your cover letter to the County Alcohol/Drug Coordinator, and any additional documents needed for specific services such as the OTP addendum.
- Complete the applicant declarations, providing truthful information about any licensing changes and criminal backgrounds related to the individuals named in the application. Sign and date the section provided.
- Input the applicant contact information. If it is different from the owner/provider information, make sure to fill out all relevant fields accurately.
- Fill out Part 2 of 2 - Facility and Personnel Information. Provide the physical address of the facility, agency contact details, and list up to two agency telephone numbers. Attach a floor plan and any required personnel materials.
- Finally, review all sections of the application to ensure completeness and accuracy. Save changes, download the form for your records, print a copy for submission, or share with your team as needed.
Begin your application process online today and ensure a smooth certification experience.
To apply for food stamps in Washington, you need to provide certain documents including proof of identity, income verification, and residency documentation. Having these documents ready simplifies the process and helps in the timely assessment of your application. By ensuring you have all necessary paperwork, you can facilitate the APPLICATION FOR CERTIFICATION OF A BRANCH OF A ... - DSHS - Dshs Wa.
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