Health Care Authority, Washington State Forms and Office Locations – Government Agency in Washington

1 - 20 of 325 forms

Form Title	Topics
09-0001-hca-board-of-appeals-electronic-service-approval-form-TA
09-0019 Enclosed bed authorization form
13-0167 Prostatic urethral lift medical necessity form
15-0336 SBHS contractor intake form
15-0337 SBHS provider contact update form
15-0339 Tribal MAC contractor intake form
15-0340 Tribal MAC designee form
15-0344 Juvenile Court MAC contractor intake form
2026 SEBB School Employee Enrollment/Change Form
2026 SEBB School Employee Enrollment/Change Form for medical only SEBB employer groups
50-0881-pebb-ltd-insurance-correction-form
80-0010 community member application and attestation form
82-0447 WISe crisis safety plan form 2023
82-0451 WISe attestation for managed care plan form 2023
82-0453 WISe attestation for tribal behavioral health form 2023
82-0637 Vehicle insurance attestation form
82-0640 Mobile crisis team grant application
82-0665 Naloxone pilot program application form
A20-AE Travel Expense Voucher Form (A20 form)
Acute inpatient rehabilitation authorization update

Health Care Authority, Washington State