Any program wishing to provide treatment to perpetrators of domestic violence must request certification from the Department of Social and Health Services.
A program may not provide direct treatment services to domestic violence perpetrators without being certified by the department. DSHS considers each geographical location of a program an individual program, and must certify each program separately.
If approved, DSHS grants certification for a two-year period.
The application and the Staff Statement of Qualifications forms are made available in the following ways:
- Application for Program Certification (form #10-209) - Word | PDF
- Staff Statement of Qualifications (form #10-210) - Word | PDF
These forms are also listed on the Electronic DSHS Forms page.
- By Mail
To request an application by mail, write to:
Domestic Violence Perpetrator Treatment Program
Department of Social and Health Services (DSHS)
P.O. Box 45710
Olympia, WA 98504-5710
Your program must submit the application, an application fee of $100, and the following documentation:
- A written statement signed by your director that the program complies with the standards contained in Washington Administrative Code (WAC) 388-60.
- Results of current criminal history background checks conducted by the Washington State Patrol for all current direct treatment program staff.
- A statement for each current paid or volunteer staff person whether or not the staff person has ever been a party to any civil proceedings involving domestic violence.
- Proof that each direct treatment staff is registered as a counselor or certified as a mental health professional with the Department of Health.
- Evidence that your program maintains cooperative relationships with agencies providing services related to domestic violence. This evidence must include:
- At least three items of evidence that you have established and continue to maintain cooperative relationships with local domestic violence victim programs and other local agencies involved with domestic violence intervention.
- Documentation that you have established a referral process between your program and the local domestic violence victim services programs.
- Proof that you participate in a local domestic violence task force, intervention committee or workgroup if one exists in your community.
- The program may also submit evidence of the following:
- Participation in public awareness activities sponsored by the local domestic violence victim services agency.
- Service agreements between the local domestic violence victim services agency(ies) and the treatment program.
- Letters of support for the program from other agencies or parties involved in domestic violence intervention.
- Evidence that the program maintains cooperative relationships with agencies involved in domestic violence intervention.