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Get WA DSHS 15-458 2015-2024

Nform you that the Adult Family Home intends to transfer or discharge you. If you do not understand this form, ask a relative or friend for help or read the resident resources on the following page. This is notice that intends to transfer or discharge you to ADULT FAMILY HOME NAME on LOCATION . DATE Reason(s) for the transfer or discharge (if needed, attach a separate sheet to add more information): 1. The transfer or discharge is necessary for the resident’s welfare and the resident’s n.

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