Pacific County Health & Human Services Special Health Care Needs: Information Request
If you are interested in receiving information related to programs and services for individuals with special health care needs, please complete the form below and our coordinator will contact you.

SMART - The SMART Team is part of the Washington State Medical Home Partnerships Project. The team consists of a group of local service providers and COEs whose goal is to help local families with timely access to Autism evaluation and  referrals to local supports and services. We have trained Centers of Excellence providers who can provide Autism evaluation and diagnosis.

CYSHCN - "In the Children and Youth with Special Health Care Needs (CYSHCN) program, we promote connected systems of care for children and youth with special care needs from birth through transition to adulthood. We work with national, state, local, and community partners to help connect CYSHCN and their families to the health and related services they need to thrive."

DDA - The Developmental Disabilities Administration offers many programs and services for those with developmental disabilities as well as providing various supports based on needs and advocating for all members of the community to help drive public policy and inclusion.

School-to-Work (S2W) - Pacific County’s School-to-Work program will aim to prepare students with developmental disabilities for employment services as they transition from high school to the work force. This program will work with Pacific County school districts, students and their families, the community, and state agencies.

Social Recreation - Monthly planned outings in Pacific County for adults with developmental disabilities.

Family Support Navigation - Resources and services to support any additional needs for families and individuals in Pacific County.

To ensure confidentiality, this form does not gather information about any children or adults needing resources or assistance. Instead, we will contact you after receiving your request.

If you have any questions, please reach out to Brianne Cline at (360) 642-9300 Ext. 2617
Sign in to Google to save your progress. Learn more
Email *
Preferred method of communication: *
Phone Number:
I would like to receive information related to the following topics, please specify if selecting "Other:"  *
Required
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of pacificcountyhealth.com.

Does this form look suspicious? Report