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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
  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 Nincy Erazo, Program Coordinator at nerazo@wapave.org or 800-572-7368 x105, or visit the website www.lifespanrespitewa.org