Kansas Open Records Act K.S.A. 45-215 et seq. REQUEST FORM
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I hereby certify that I will not
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(A) use any list of names or addresses contained in or derived from the records or information
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https://www.dcf.ks.gov/Records/Documents/KansasOpenRecordsAct_RequestForm.pdf
☐ African ☐ American Indian/Alaska Native ☐ Asian ☐ Black/African American
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Caregiver Email
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Case Manager Email
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Primary Physician Email
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https://www.dcf.ks.gov/services/PPS/Documents/SE Resources/BI_Program_Referral.pdf
If it is in fact an
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to the Family First Grantee (Provider) (shown in the box below by region), Regional Family First Email Inbox (shown in Section 1), and the Region’s FACTS Email Inbox
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_4000_Forms/PPS4311_Instr.pdf
State of Kansas Department for Children and Families Prevention and Protection Services Referral for QRTP Assessment For Child
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Email Address
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Once this form is complete please email to
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5115.pdf
DEPARTMENT FOR CHILDREN AND FAMILIES - ECONOMIC AND EMPLOYMENT SERVICES POLICIES AND PROCEDURES
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exchange of Federal Tax Information via both e-mail and facsimile are strictly prohibited
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https://content.dcf.ks.gov/EES/KEESM/Appendix/X-7_safeguard_2018.pdfView duplicates
State of Kansas PPS 3059B Department for Children and Families
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Phone/Email
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Family Waiver Care: 785-296-9551 or email tawaiver@family-waiver-care.com
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3059B.pdf
66603 Website: http://www.dcf.ks.gov Email: DCF.FCLExceptions@ks.gov Request for Amendment
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Agencies Complete and return by email to: DCF.FCLExceptions@ks.gov Describe the reason for
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 652 Amendment for CPA.pdf
FCL 656 Rev. 09/25 KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES Foster Care Licensing 500 SW Van Buren Street 2 nd Floor Topeka, Kansas 66603 Website
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Email Address
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 656 CPA Withdrawal of Sponsorship.pdf
Amendment Number: 1 Grant RFP: SNAP Outreach RFP
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E-Mail Address: william.heckard@ks.gov
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Agency: Kansas Department for Children and Families
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Conditions: Please see response to questions
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https://www.dcf.ks.gov/Agency/Operations/Documents/RFP SNAP Outreach Amendment.pdf
Amendment Number: 1 Grant RFP: We Kan Drive RFP
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E-Mail Address: William.heckard@ks.gov
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Agency: Kansas Department for Children and Families
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Conditions: Please see response to questions
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https://www.dcf.ks.gov/Agency/Operations/Documents/RFP WKD QA Amendment.pdf