Position/Title of individual completing referral
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Email address of individual completing referral
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Phone number of individual completing referral
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Which services are you interested in
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https://www.dcf.ks.gov/services/RS/Documents/RS Forms/General.Referral.Pre-ETS.pdf
be sent to the mailing address or email listed above with appropriate payment (see Payment
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Return Results by: Encrypted email (list if different than above): Postal Mail
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https://www.dcf.ks.gov/Agency/Operations/Documents/OBI/OBI_1011_CAN_ROI.pdf
Mission: Working in partnership with Kansans with disabilities to achieve their goals for
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DRAFT / Email comments by January 17, 2020 to Margaret.Spencer@ks.gov 2 3. Percent of
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https://www.dcf.ks.gov/services/RS/Documents/goals and priorities 2020.pdf
Kansas Social Services Block Grant Proposed State Plan for SFY 2020 SSBG Proposed State Plan
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555 S. Kansas Ave., Topeka, KS 66603-3444, 785-296-0761, email Daniel.Lewien@ks.gov
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https://www.dcf.ks.gov/Newsroom/Documents/ProposedSSBG_StatePlanSFY2020.pdf
Kansas Social Services Block Grant State Plan for SFY 2023 Page 1 TITLE XX: SOCIAL
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Management, 5th Floor, 555 S. Kansas Ave., Topeka, KS 66603-3444, 785-296-0761, email
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https://www.dcf.ks.gov/Agency/Documents/SSBG State Plan SFY2023.pdfView duplicates
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
TITLE IV-B CHILD AND FAMILY SERVICES PLAN
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U.S. Department of Health and Human Services
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This 2023 Annual Progress and Services Report (APSR) is the third annual report related to the
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https://www.dcf.ks.gov/services/PPS/Documents/FY2023DataReports/Public Website Documents/Kansas TITLE IV-B APSR 2023 resubmitted 8.25.2022.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
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