CWCMP Office Address: Supervisor: Phone: Email: Case Manager: Phone: Email: Support Worker (if applicable): Phone: Email: Current Caregiver/Placement: Name: Child
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5310.pdf
DEPARTMENT FOR CHILDREN & FAMILIES CERTIFICATION FOR ORIGINAL IDENTIFICATION CARD
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This form must be completed by DCF/Provider staff
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Email Address
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This form is proof of social
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Email to
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_7F.pdf
Email: jalbert@mchks.com
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Email: erna.schmidtberger@haysmed.com
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Email: suicor@hhf.ks.org
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Email: carol.schopf@mercy.med
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Email: collection@ohscompare.com
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Email: rcradic@saint.lukes.org
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https://content.dcf.ks.gov/EES/KEESM/Implem_Memo/collection-site-address-list 7-1-14.pdfView duplicates
Is Vocational Rehabilitation the right program for you
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• VR serves people with any type of
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EMAIL ADDRESS CONTACT PERSON’S NAME AND PHONE NUMBER (someone who would be able to give you
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https://www.dcf.ks.gov/services/RS/Documents/RS Forms/VR Application_PDF.pdf
Date of Birth: Cell Phone: ( ) E-mail: Cell Phone: ( ) E-mail: Race/Ethnicity: (check all that apply
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5320.pdf
The contents of the PPS Policy and Procedure Manual include: A. Policies which define required or prohibited actions
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Policies may contain the following language: 1. Statements
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Policy_and_Procedure_Manual_January2024.pdfView duplicates
Inter Ethnic Placement Act (MEPA/IEPA
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Policy_and_Procedure_Manual.pdfView duplicates
THIS AGENCY HAS BEEN APPROVED BY THE KBI TO SUBMIT FINGERPRINTS ELECTRONICALLY
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PLEASE SUBMIT COMPLETED FINGERPRINT SUBMISSION VIA LIVESCAN
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Failure to follow instructions may result in
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https://www.dcf.ks.gov/Agency/Operations/Documents/OBI/LEA-DCF Forms.pdf
FP-1020 10/21 Page 1 of 1
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Kansas Department for Children and Families
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Instructions: *REQUIRED FIELDS Please Fill in ALL Lines on this Form
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*Have You ever been fingerprinted for DCF
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FP-1020 With Waiver.pdf
Child in the Home or Pregnant Woman
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Economic and Employment Services (EES) provides a variety of programs that
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Email with Client Name and KEES Case Number Sent to Appropriate Mailbox
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https://www.dcf.ks.gov/Agency/Testimony/Documents/2023/1.26 H WF Employment Jobs Programs.pdf