Rev. 06/24 KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES
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PO Box 1424 Topeka, Kansas 66601-1424
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Request for Exception for Child Placement Agency
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Use this form to request an exception to
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Email
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 657 CPA Request for Exception.pdf
State of Kansas Department for Children and Families Prevention and Protection Kansas Statute Annotated
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_2A.pdf
Strong Families Make A Strong Kansas Form OGC-xxxx
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The Contract Transaction Report will NOT be processed WITHOUT a Contract Status Report, a Contract Itemization Report and any other
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https://www.dcf.ks.gov/Agency/Operations/Documents/Contract Itemization Report (OGC-2004) ACCESSIBLE 5-2017.pdf
State of Kansas Department for Children and Families IS-4315 Economic and Employment Services
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Employment Services (ES) Referral to Vocational Rehabilitation (VR) Client
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CN Email
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https://content.dcf.ks.gov/EES/KEESM/Forms/IS-4315EmploymentServicesReferraltoVocationalRehabilitation08-21.pdfView duplicates
(not needed for Imprest or SinglePay
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above within the first 10 days of each month after services are
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provide 10 working days’ notice if need exists to terminate this agreement early
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_2000_Forms/PPS2833.pdf
State of Kansas PPS 5258a CCEP Program Department for Children and Families REV 8/11/22
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from the invoice, include them in your e-mail so the payment can be processed without delay
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5258A.pdf
Provide the names and affiliations of the individuals who participated in the statewide assessment process; please also note their roles in the process
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https://www.dcf.ks.gov/services/PPS/Documents/CFSR/Kansas Statewide Assessment 2023.pdf
DOB APPROVAL STAMP (If Required) Revised 05/03/2022
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Department for Children and Families Rebecca Gerhardt 785-296-3825
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Agency Agency Contact Contact Phone Number
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https://www.dcf.ks.gov/Newsroom/Documents/Economic_Impact_Statement-Rules_and_Regulations-JCIC 9-22-2023.pdf
(Donor must have picture ID to show to collection site personnel
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Type of Test to Be Conducted: Drug Test (NIDA/5) Panel
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Normal Collection - H39 Screen 5, PCP
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852-5201 or email
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https://content.dcf.ks.gov/ees/KEESM/Forms/ES-4108_Collection_Site_Passport.pdfView duplicates
Send a scan of the form to the EBT Unit as an attachment to an e-mail to DCF.EBTMAIL@ks.gov
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portions of the form are completed, email the completed form to the Administrative Office
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-3142EBT_Ben_Repay05-22.pdfView duplicates