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
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
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
DCF Provider Agreement Each regional office has a person(s) assigned to create and maintain provider agreements
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This person is referred to as the Provider Agreement Specialist (PAS
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Email
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https://www.dcf.ks.gov/services/PPS/Documents/FY2025 DataReports/Misc/Provider Agreement - Regional Contacts.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
EES Policy No. 23-07-07 RE: Replacement of Stolen EBT Benefits due to card skimming, card
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benefits can be submitted verbally in-person or by phone or in writing through email or mail
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https://content.dcf.ks.gov/ees/KEESM/Policy_Memo/23-07-07FoodAssistanceReplacementofStolenEBTBenefits.pdfView duplicates
LOW INCOME ENERGY ASSISTANCE PROGRAM (LIEAP) 8-24-A
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How can you apply for LIEAP
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Log In to the online portal to begin
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You can return it to us
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By email
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By fax To find your local DCF office
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-3500_LIEAP_ENGLISH_10-20.pdfView duplicates
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 8.24.pdfView duplicates
your additional correspondence recipient address and point of contact name, phone, and email
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Program Name: KEHS- Address: City: State: Zip: Contact Name: Phone: Email
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https://content.dcf.ks.gov/ees/KEESM/Forms/ES-1610-KansasEarlyHeadStartChildCarePartnershipsReferralForChildCareAssistance.pdfView duplicates
Email Address
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Do you have a voicemail set up
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How many people live in your household
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Are you responsible for caring for a disabled person daily
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Do you have minor children who are
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https://content.dcf.ks.gov/EES/KEESM/Appendix/E-6FAETSelfAssessment06-19.pdfView duplicates