Skip Ribbon Commands
Skip to main content
Skip Navigation

Apply Now, Eligibility Status, and more

Apply for Services
Prevention and Protection Services

Appendices and Miscellaneous Forms

Listing of key staff
Form Number Form Date Form Name Form Other Languages
ADM-3465 12/2011 Invoice and Timesheet Purchase of Service xls  
Appendix 0A Expanded History Check Letter doc  pdf  
​Appendix 0B ​01/2024 ​Critical Incident Review Staff Interview ​doc  pdf
​Appendix 0C ​07/2019 ​Critical Incident Review Observations doc  pdf
​Appendix 0D ​01/2025 ​Initial TDM Protocol doc  pdf
​Appendix OD1 ​01/2025 ​Placement Stability TDM Protocol doc  pdf
​Appendix 0E ​01/2025 ​Initial TDM Meeting Scheduling Form doc  pdf​
​Appendix 0F ​10/2019 ​Initial TDM Worker Quick Presentation doc  pdf
​Appendix OF1 ​01/2025 ​PS-TDM Worker Quick Presentation Outline     doc  pdf
​Appendix OF2 ​01/2025 ​PS-TDM Supervisor Guide​     doc  pdf
​Appendix OF3 ​01/2025 ​TDM Key Elements doc  pdf
​Appendix 0G ​10/2019 ​Supervisor Consultation for Initial TDM Meeting ​doc  pdf
​Appendix 0H ​10/2019 ​Supervisor Guide to Initial TDM Meeting doc  pdf
​Appendix 0I ​10/2019 ​Worker's Guide for an Effective TDM Meeting doc  pdf
​Appendix 0J ​10/2019 ​Guide for Discussion of Risk and Safety Assessment Initial Removal TDM doc  pdf
​Appendix 0K ​10/2019 ​Tips for Supervisors for Effective TDM doc  pdf
​Appendix 0L ​10/2019 ​Tips for Workers for Effective TDM doc  pdf
​Appendix 0M ​01/2025 ​Initial TDM Form ​doc  pdf spadoc  spapdf
Appendix 0N ​07/2025 ​Meetings with Families doc  pdf
​Appendix 0P ​01/2023 ​Family Meeting Map ​doc  pdf​
​Appendix 0Q ​07/2025 ​TDM Brochure pdf spapdf
Appendix 0R ​07/2025 ​Family Meeting Brochure ​pdf spapdf​
​Appendix 1A ​07/2025 Kansas Intake Guidance doc  pdf
​Appendix 1B 07/2025 ​Factors to Consider Before Leaving a Child at Home Alone  pdf ​spapdf
​Appendix 1C 10/2012​ ​Child Abuse and Neglect-Protective Services Alert Report doc  pdf
​Appendix 1E ​07/2021 ​Adult Protection Services Initial Assessment Guide doc  pdf
​Appendix 1J 01/2023 ​Disability/Special Needs Table doc  pdf
​Appendix 2A ​07/2016 ​Kansas Statute Annotated- Sexual Abuse Definitions doc  pdf
​Appendix 2B 07/2025 Guide for Assessment and Decisions doc  pdf
Appendix 2E​ ​01/2025 DCF Case Finding History​ doc  pdf
Appendix 2F​ ​07/2013 Six Areas of Family Life for Assessment​ doc  pdf
​Appendix 2G ​07/2016 ​KIDS Upload Instructions doc  pdf
​Appendix 2H ​01/2021 ​Safety Assessment doc  pdf
​Appendix 2I ​01/2017 ​Interview Guide for Runaway and Truant Children doc  pdf
​Appendix 2J ​01/2017 ​Caregiver Protective Capacity Factors doc  pdf
Appendix 2K ​01/2021 ​Lasting Safety Tips Sheet doc  pdf
​Appendix 2L ​07/2017 ​Factors to Guide the Plan of Safe Care doc  pdf
​Appendix 2N ​07/2022 ​My Three Houses/Three Pages  ​doc  pdf spadoc  spapdf
​​Appendix 2N ​07/2022 ​My Three Houses/One Page doc  pdf
​Appendix 2O ​01/2021 ​Fairy Wizard Instructions doc  pdf ​spadoc  spapdf
​Appendix 2P ​01/2020 ​Fairy Wizard Template doc  pdf
​Appendix 2W ​01/2020 ​Ecomap Template doc  pdf
​Appendix 2Z ​07/2021 Copying from Microsoft Word into KIDS​ doc  pdf
​Appendix 3A ​01/2018 ​Fatherhood Involvement Guide ​doc  pdf
​Appendix 3B ​01/2020 ​Basic Genogram Symbols doc  pdf
​Appendix 3C ​Ecomap Symbols pdf
​Appendix 3D 07/2013 ​Medical List doc  pdf
​Appendix 3E ​Time Line Example doc  pdf
​Appendix 3F 10/2012​ ​Early Reunification Prognosis Indicators doc  pdf
​Appendix 3G 01/2024 ​Foster Parent Report to the Court doc  pdf spadoc spapdf
​Appendix 3H 07/2012​ ​Case Plan Documentation Checklist doc  pdf
​Appendix 3I ​07/2023 ​Mental Health Workflow doc  pdf
​Appendix 3J 10/2012​ ​Child Welfare Mental Health Referral Guide doc  pdf
​Appendix 3JI ​07/2025 ​Screening Tool for Federal Benefits doc pdf
​Appendix 3K 07/2019 ​Request for Initial Mental Health Assessment/Transfer of Services ​pdf​​
​Appendix 3L 10/2012​ ​Social Emotional Screening Tool doc  pdf
​Appendix 3M ​01/2025 ​Family Mobile Crisis Line doc  pdf ​spadoc  spapdf
Appendix 3N 01/2018​ ​Family Finding Search Websites doc  pdf
​Appendix 3Q 10/2012​ ​Case Review Timeline doc  pdf
​Appendix 3S 04/2018​ ​Permanency Staffing Guide doc  pdf
​Appendix 5A ​07/2020 ​Icebreakers Brochure pdf ​spadoc  spapdf
​Appendix 5B ​01/2025 ​Non-Licensed Placement​ Crisis Support Information Acknowledgement​
​doc  pdf             spadoc  spapdf
​Appendix 5C ​07/2021 ​Relative Placement Assessment doc  pdf
​Appendix 5D ​04/2018 ​Supervisor Consultation Guide ​doc  pdf
​Appendix 5E ​01/2013 ​Consular Notification and Access Fact Sheet doc  pdf
​Appendix 5F 10/2012​ Requesting SS Card doc  pdf
​Appendix 5G 01/2021 ​Notification to Parent Considering Relinquishment doc  pdf
​Appendix 5G1 ​01/2021 ​Acceptance of Relinquishment of Parental Rights doc  pdf
​Appendix 5G2 ​01/2021 ​Refusal of Relinquishment of Parental Rights ​doc  pdf
​Appendix 5H 07/2024​ ​Consent for Release of Information doc  pdf spadoc​ spapdf
​Appendix 5J 01/2025 ​Relinquishment of Minor Child to Agency doc  pdf ​ 
​Appendix 5K 10/2012​ ​OPPLA CA doc  pdf spadoc spapdf
​Appendix 5L 10/2012​ ​Custodianship CA doc pdf spadoc spapdf
​Appendix 5M ​01/2014 ​Referral to DCF for Continued Services doc  pdf
​Appendix 5O ​01/2020 ​Kansas Foster Parents' Rights doc  pdf
​Appendix 5P ​07/2019 ​Educational Stability Process Map doc   pdf
​Appendix 5Q 01/2023​ Authorization to Disclosure Information, Including Child(ren)'s Individual Identifiable Health Information​ ​doc​  pdf spadoc​  spapdf
Appendix 5R​ ​07/2019 ​Checklist for Request for Consent to Adopt  doc  pdf
Appendix 5S​ ​01/2024 ​Best Interest Staffing for Children in Foster Care Brochure doc  pdf
Appendix 5T​ ​01/2017 ​Adoption from Foster Care Brochure doc  pdf
Appendix 5U​ ​07/2014 ​Disability Determination Referral to Kansas Legal Service doc  pdf
​Appendix 5V ​07/2014 ​Guide to Understanding SSI and the DCF/KLS Contract doc  pdf
​Appendix 5W ​01/2017 ​Preparing Children for Adoption doc  pdf
​Appendix 5Y ​07/2019 ​Letter to Parents Considered at a BIS doc  pdf
​Appendix 5Z ​07/2018 ​Normal Phases of Pre-Finalization ​doc  pdf
​Appendix 6A 07/2016​ ​Permanent Custodianship Subsidy Brochure pdf
​Appendix 6B 01/2014​ ​Adoption Assistance Brochure pdf
Appendix 6C​ 01/2025 ​Legal Fee Reimbursement for Adoption doc  pdf spadoc  spapdf
Appendix 6D​ 02/2018 ​Annual Adoption Assistance Review-Second Notice doc  pdf spadoc  spapdf
Appendix 6E​ ​07/2017 ​Adoption Assistance Repayment Agreement doc  pdf
​Appendix 6F ​07/2023 ​Adoption and Permanent Custodianship Information doc  pdf
​Appendix 7A 07/2015​ ​Youth Advisory Council Handbook doc  pdf
​Appendix 7B 10/2012​ ​Application for KYAC Membership doc  pdf
​Appendix 7C 01/2020​ ​National Youth in Transition Database doc  pdf
​Appendix 7C Definitions ​01/2020 ​Federal Question Definitions doc  pdf
​Appendix 7E 07/2020 ​Checking and Clearing Credit History for Youth doc  pdf
Appendix 7F​ ​01/2015 ​Certification for Identification Card pdf
​Appendix 9B 07/2025 ​ICPC Supervision Report-90 Days doc  pdf​
​Appendix 9C 10/2012​ ​ICPC Supervision Report-30 Days doc  pdf
Appendix 9D​ 07/2015​ ​Interstate Compact on the Placement of Children Articles and Regulations doc  pdf
Appendix 9F​ ​07/2014 ​ICPC Medial Card Process xls   pdf
Appendix 9G​ ​07/2013 ​Sample Reg 7 Court Order doc  pdf
Appendix 9H​ ​07/2014 ​ICPC Referral Checklist doc  pdf
​Appendix 9I ​07/2016 ​Interstate Compact on Adoption and Medical Assistance doc  pdf
Appendix 10A​ ​07/2023 ​Adult Protective Services Statutes doc  pdf
​Appendix 10B ​07/2016 ​APS Guidelines to consider when making a finding doc  pdf
​Appendix 10C ​7/2021 ​Records to Obtain During Investigation doc  pdf
​EP Appendix A ​​ ​Kansas AFDC Needs Standards doc  pdf ​ 
​EP Appendix B 10/2012​ ​Computer Systems doc  pdf
​EP Appendix D 08/2016 ​Computer Systems-WARDS Users Handbook doc  pdf
   ​​​​​​​​​​​​​​​​​​​​​​​​