| Resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Password must contain the following:
  • 12 Characters
  • 1 Uppercase letter
  • 1 Lowercase letter
  • 1 Number
  • 1 Special character
Lifespan Respite Logo
Please note:  
Lifespan Respite WA is closed for its annual winter break from December 23, 2024, to January 2, 2025. This is essential for our team to take time to rest, renew, and recharge. We look forward to working with you in 2025.
Agency Information
Note that this information may be visible to potential clients on our website.













Agency Contact(s)







Services Provided




Skilled Nursing or Medical Supports Provided

Is your agency able to assist those seeking respite in these areas?


In order to have become a fully executed RPA the following steps will need to be completed:
  1. Submit this RPA Application with all required information.
  2. Submit certificates of insurance with PAVE and State of Washington, Dept. of Social and Health Services (DSHS) listed as “additional named insureds”. This is required even if you are already a registered provider with DSHS; Lifespan Respite/PAVE is a separate program. Which type of insurance certificates are needed depend on your business requirements and can be found in our Policies and Procedures on the website.  Addresses for Certificates of Deposit
  3. Sign and submit the Interagency Agreement, as executed by the authorized agency signatory which is available on the website.


Maximum file size is 50 MB


Maximum file size is 50 MB





Maximum file size is 50MB. Accepted file types are .bmp, .gif, .jpg, .jpeg, .png, .tif



If you have additional questions, contact the Program Coordinator at giverespite@wapave.org or call us at 253-442-3214.
Save my progress and resume later | Resume a previously saved form

Contact Information