Contractor Updates and Changes


There are two categories of changes that contractors may request – Administrative Contract Changes and Contract Revisions and Amendments.

Administrative Contract Changes

The following administrative changes are to be sent as an email notice to DSHS within ten calendar days of the change but do not require prior approval from DSHS:

  • Contact name, phone, fax, mailing address, and/or email address for any of the following positions:
    • Executive director
    • Financial officer
    • Project director or coordinator
    • Case manager
    • Outreach contact
    • Billing contact
    • Data contact
    • Public information contact
  • A cost reimbursement contract for less than $100,000 and the cumulative transfer of funds among direct cost categories (except equipment) exceeds 10% of the total budget. The total budget amount is unchanged. NOTE: Cumulative transfers of funds among direct cost categories that are 10% or less do not require notification to DSHS.
  • A change in the contractor’s share of the budget via program income or match, regardless of the amount of the change.
  • Minor wording corrections or clarifications

Administrative change notices may be sent at any time during the contract period.

To submit administrative changes:

Send an email detailing the changes to . Your information will be updated and you will receive a reply.

Contract Revisions and Amendments

All other requested contract changes that are not administrative changes will constitute either a contract revision or amendment if approved. All requests must be submitted to allow for processing and approval before the last 90 days of the contract period. Requests submitted within the last 90 days are considered on a case by case basis.

To initiate, complete a Contract Revision Request (CRR) form located here. If the change involves a change in a clinic location or hours of service, also complete the applicable Clinic Change form below.

Clinic Change Forms

Breast and Cervical Cancer Services Site Form (28KB, Word)
Epilepsy, Primary Health Care, and Title V Maternal & Child Health Site Form (41KB, Word)
Prenatal Clinic Site Form (100KB, Word) 
Family Planning Site Form (45KB, Word)

To submit contract revisions or amendments:

  1. Download the CRR form and any applicable Clinic Change forms.
  2. Fill out and complete the forms as Word documents by using "save as" to rename.
  3. E-mail the forms as an attachment to .
  4. DSHS staff will review the forms and contact you to process the revision or amendment.
  5. Original agency signatures may be requested for the CRR.

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Last updated June 11, 2013