(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
The Kansas Department for Children and Families (DCF) works with approximately 750 youth from
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please call 785-296-3944 or send an email to dcf.H4H@ks.gov. Wrapped gifts and gift cards
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https://www.dcf.ks.gov/services/PPS/Documents/HopeForTheHolidays.pdf
STUDENT EMAIL ADDRESS EXPECTED DATE TO COMPLETE OR EXIT HIGHSCHOOL CURRENT GRADE LEVEL OF
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IF NO, DO YOU HAVE AN
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PARENT, GUARDIAN, REPRESENTATIVE PHONE CELL PHONE EMAIL ADDRESS 4/2/2019
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https://www.dcf.ks.gov/services/RS/Documents/RS Forms/Pre-ETS_Request_2.pdf
you are testifying via WEBEX, be sure your email is provided in this cover letter so I can email the link to you prior to the meeting
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https://www.dcf.ks.gov/Agency/Testimony/Documents/2023/HB 2021 DCF Written Only.pdf
Page 1 of 19 FCL 403
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of Applicant/Licensee (exactly as it appears on the license) Telephone Number Email Address
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Surveyor’s Signature Agency Represented Email Address Date
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL_forms/FCL_403_FFHSurveyInstrument-CPA.PDFView duplicates
Evaluation Referral Click here to open email to: mailto:SafeCareKS@cmh.edu Once email opens, attach saved form PPS 2450 Rev
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PPS SPECIALIST’S EMAIL ADDRESS
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_2000_Forms/PPS2450.pdf
Street 2 nd Floor Topeka, Kansas 66603 Website: http://www.dcf.ks.gov Email: DCF.FCL@ks.gov
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Topeka, Kansas 66603 Website: http://www.dcf.ks.gov Email: DCF.FCL@ks.gov FCL 662 Rev. 06/24
https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 662 Relative and Non-related Kinship Renewal Application.pdf
Include: Name, Agency, Mailing Address, Telephone Number, Fax Number and E-mail Address
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phone and/or email if available
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Family new phone/email
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Child-only new phone/email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_9000_Forms/PPS9121.pdf
Is Vocational Rehabilitation the right program for you
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• VR serves people with any type of
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EMAIL ADDRESS CONTACT PERSON’S NAME AND PHONE NUMBER (someone who would be able to give you
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https://www.dcf.ks.gov/services/RS/Documents/RS Forms/VR Application_PDF.pdf