Get Wa Dshs 13-836 2008-2026

The WA DSHS 13-836 form is essential for renewing medical benefits. Completing this form online ensures a streamlined process to maintain your coverage each year. This guide provides step-by-step instructions to help you fill out the form accurately.

Follow the steps to complete the WA DSHS 13-836 online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter your Client ID Number in the designated field. This number is essential for identifying your case.
3. Provide your personal information including your first name, last name, and middle initial in the corresponding sections. Ensure that all names are spelled correctly.
4. Input your date of birth in the required format. This information helps confirm your identity.
5. Fill in your current address including the city, state, and ZIP code. If your mailing address is different, provide that information in the next section.
6. Complete the fields for your home phone number and cell phone number, including the area code. If possible, provide a reliable email address for communication.
7. Indicate if anyone has moved into your home in the past 12 months by checking 'Yes' or 'No'. If yes, list their name, date of birth, gender, citizenship status, and relationship to you.
8. If anyone has moved out of your home, check 'Yes' or 'No'. If applicable, provide the name, social security number, and date they moved out.
9. Answer whether anyone in the household started receiving private health insurance, and, if so, provide the details of that person and the insurance.
10. List all monthly earned or unearned income for your household. Provide the employer's name and phone number alongside the name of the person earning the income.
11. Enter the total monthly income before taxes in the specified field. Be sure to gather proof of income as required.
12. Report any expenses your household pays such as child care costs and child support. Fill in the amounts in the designated areas.
13. Review the entire form for accuracy and completeness. Ensure that any required documentation proving your income is prepared to be submitted with the form.
14. Once you have completed the form, save any changes, and choose to download, print, or share the form as necessary.

Complete your forms online today to maintain your medical benefits without interruption.