Department of Health Adverse Events Reporting Program
State law requires health care facilities to report to the Washington State Department of Health whenever an adverse event is confirmed (Chapter 70.56 RCW).

Use this electronic form to report a confirmed adverse event at your facility. (A print notification form is also available on the Adverse Events website.) To complete this electronic notification form:
  • Enter all requested information
  • Review the list of 29 adverse events (effective Oct. 1, 2012) to select the appropriate event type.
  • Upon completion click on the "submit" button.
  • To report multiple events at the same facility you will need to "start" another form.
  • Our office may contact you with questions about the information submitted.
  • Adverse event information will be reported on the quarterly reports.
  • View the Adverse Events website to learn more about the reporting requirement.

For questions about the Adverse Events Reporting Program, please contact Kathy Schmitt by phone at (360) 236-2869 or email Kathy Schmitt at