the use of the TDM Request Form, in addition to communication via phone, in-person or email
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hours that a TDM is needed, the CPS Specialist shall notify the TDM Scheduler via email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_0D.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
State of Kansas PPS 3059C Department for Children and
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Email/Phone
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Alternative Email or Social Media Contact
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If you have any NYTD questions, please email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3059C.pdf
UNIVERSAL PACKET SERVICE ENTRY AUTHORIZATIONS Client Name
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_ Initial when applicable Authorization Explanation Exceptions of By signing below and initialing, the client
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E-mail Address
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https://www.dcf.ks.gov/services/PPS/Documents/FY2025 DataReports/Misc/2025 kdads-universal-packet-fillable-form 3.5.2025 final accessible.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
Introduction The Summary of Prevention and Protection Services (PPS) Policy and Procedure Manual Changes provides a list of policies, forms, and appendices with explanations for the
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Summary of Changes/Summary of Changes - 2025.7a.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
☐ 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
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