NOTICE TO PARENT: This is an important legal document and by signing it you are permanently giving up all custody and other parental rights to the child named herein
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_5J.pdf
KANSAS DEPARTMENT FOR CHILDREN & FAMILIES JOINT COMMITTEE ON CHILD WELFARE SYSTEM OVERSIGHT SECRETARY LAURA HOWARD | 6.2.20253 | BYTHE NUMBERS 7 | REQUESTED QUARTERLY DATA 20 | HB2075
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https://www.dcf.ks.gov/Agency/Testimony/Documents/2025/6.2 DCF CWSO Updates Final.pdf
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
KFSC is a part of the Kansas Center for Autism Research
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Training (KCART) at the University of
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E R V I C E S Contact us via email (kfsc@kumc.edu) or our phone line (913-897-8471) for more
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https://www.dcf.ks.gov/services/PPS/Documents/SE Resources/KFSC.pdf
Return to: DCF.KSADPSearch@ks.gov OR DCF/Prevention and Protection Services 555 S. Kansas Ave 4 th Floor Topeka, KS 66603 PPS 0330 REV. Jan-25
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Note: This form is to be used by
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Email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_0000_Forms/PPS0330.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
Appendix 0E Department for Children and
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The TDM Scheduler will invite professionals if email address is available
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Phone number/email address
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For scheduling, email the completed form to
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_0E.pdf
This supplemental summary of change includes substantial changes prompted by Kansas House
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The Summary of Prevention and Protection Services (PPS) Policy and Procedure Manual Changes
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Summary of Changes/Summary of Changes - 2025.7b.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