| Form Number |
Form Date |
Form Name |
Form |
Instructions |
Other Languages |
|---|
| PPS 10000 |
01/2015 |
Kansas Protective Services for Vulnerable Adults Brochure |
pdf |
|
spapdf |
| PPS 10001 |
07/2018 |
Understanding Your Role as Power of Attorney |
pdf |
|
spapdf |
| PPS 10050 |
02/2022 |
Financial Exploitation |
doc pdf |
|
|
| PPS 10100 |
07/2016 |
Adult Protective Services Intake |
doc pdf |
|
|
| PPS 10110 |
07/2021 |
Adult Protective Service Screening Report |
doc pdf |
|
|
| PPS 10120 A |
07/2022 |
Potential Criminal Notification Coversheet |
doc pdf |
|
|
| PPS 10125 |
07/2016 |
Notification to KDADS |
doc pdf |
|
|
| PPS 10130 |
07/2020 |
Notice of Action to Reporters for Adult Abuse Reports |
doc pdf |
|
|
| PPS 10200 |
10/2012 |
Adult Protective Services Case Activity Log |
doc pdf |
|
|
| PPS 10204A |
07/2020 |
Notice of Allegation Change |
doc pdf |
|
|
| PPS 10205 |
07/2014 |
Your Rights During an Adult Protective Services Assessment for Self-neglect |
doc pdf |
|
spapdf
|
| PPS 10208 |
07/2014 |
Your Rights during an APS Investigation Brochure |
pdf |
|
spapdf |
| PPS 10209 |
01/2025 |
Bank Release of Records |
doc pdf |
|
|
| PPS 10210 |
10/2012 |
Authorization for Release of Confidential Information |
doc pdf |
|
|
| PPS 10211 |
01/2025 |
Release of Records Relevant to Adult Protective Services Investigation |
doc pdf |
|
|
| PPS 10212 |
01/2014 |
APS Critical/Significant Incident Report |
doc pdf |
|
|
| PPS 10215 |
07/2021 |
Non-Critical Death Notification |
doc pdf |
|
|
| PPS 10224A |
01/2024 |
Cornell-Penn Interview for Decisional Abilities (IDA) Kansas Edition - 3.0 |
pdf |
|
|
| PPS 10224B |
01/2025 |
Cornell-Penn Interview for Decisional Abilities (IDA) Kansas Edition - 3.0 (28 pt. font) |
pdf |
|
|
| PPS 10224C |
01/2025 |
Cornell-Penn Interview for Decisional Abilities (IDA) Kansas Shortform |
pdf |
|
|
| PPS 10224D |
01/2025 |
Cornell-Penn Interview for Decisional Abilities (IDA) Kansas Shortform (28 pt. font) |
pdf |
|
|
| PPS 10230 |
07/2024 |
Interview Notice to Alleged Perpetrator |
doc pdf |
|
spadoc spapdf |
| PPS 10231 |
07/2025 |
Involved Adult Interview Request Letter |
doc pdf |
|
|
| PPS 10240 |
07/2012 |
What you need to know about Investigations of Adult Abuse, Neglect, Exploitation, or Fiduciary Abuse |
pdf |
|
spapdf |
| PPS 10250 |
01/2023 |
Corrective Action Plan |
doc pdf |
doc pdf |
|
| PPS 10300 |
07/2021 |
Notice of Agency Decision |
doc pdf |
|
spadoc spapdf |
| PPS 10310 |
07/2021 |
Notification to Regional Adult Abuse/Neglect Registry Contact |
doc pdf |
|
|
| PPS 10315 |
07/2021 |
Notice of Termination of Corrective Action Plan |
doc pdf |
|
|
| PPS 10320A |
01/2017 |
Notice of APS Case Closure- For Self Neglect Cases |
doc pdf |
|
spadoc spapdf |
| PPS 10320B |
07/2016 |
Notice of APS Case Closure - Non Self Neglect Cases |
doc pdf |
|
|
| PPS 10322A |
01/2023 |
APS Confirmation Finding for Crisis Excpetion Requests |
doc pdf |
|
|
| PPS 10330 |
01/2013 |
Appeal Summary |
doc pdf |
|
|
| PPS 10340 |
07/2021 |
Notification to Facility Regarding APS Finding |
doc pdf |
|
|
| PPS 10350 |
07/2021 |
Substantiation Notification to Law Enforcement |
doc pdf |
|
|
| PPS 10360 |
07/2021 |
Report to State Regulatory Authority from APS Regarding Finding of Abuse, Neglect, or Exploitation |
doc pdf |
|
|
| PPS 10370 |
01/2018 |
ANE Unit Cover Sheet |
doc pdf |
|
|
| PPS 10400 |
07/2022 |
Adult Abuse, Neglect, Exploitation, Fiduciary Abuse Central Registry |
doc pdf |
|
spadoc spapdf |
| PPS 10500 |
07/2016 |
Adult Protective Service Plan |
doc pdf |
|
|
| PPS 10510 |
07/2016 |
Emergency APS Admissions to Nursing Facilities |
doc pdf |
|
|
| PPS 10600A |
01/2015 |
Adult Guardianship / Conservatorship Referral/Notification |
doc pdf |
|
|
| PPS 10600B |
01/2019 |
Youth Guardianship / Conservatorship Referral |
doc pdf |
|
|
| PPS 10610 |
01/2017 |
Decision-Making and Functional Assessment: Criteria for Legal Impairment a Multi-disciplinary Tool |
doc pdf |
|
|