State of Kansas Aftercare Contact Agreement for Young Adults PPS 3070A
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Department for Children and Families (For Cases Where Young Adult is not in the Custody of the Secretary
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Email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3070A.docx
Individuals Determined to Have Achieved an Employment Outcome
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The provision of services under the individual's IPE has contributed to the achievement of the employment outcome
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https://www.dcf.ks.gov/services/RS/Documents/Policy/SEC_5-1.docx
Section 7 Pre-Employment Transition Services (Pre-ETS
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Protection, use, and release of personal
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or Manager receives a call or email regarding a concern from the Client Assistance Program
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https://www.dcf.ks.gov/services/RS/Documents/Policy/SEC_7-14.docx
Last Name First Middle Date of Birth / / Maiden name or other names known by Social Security Number
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(PLACE YOUR INITIALS TO THE LEFT OF EACH ITEM APPROVED
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Email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_0000_Forms/PPS0100.doc
Prevention and Protection Services PPS 10350
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REV 07/2021 Notification to Law Enforcement
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Please type or print Involved Adult: Name Date Received by
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Adult Protective Specialist Email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_10000_Forms/PPS10350.doc
DCF REGION: SERVICE COUNTY: PROVIDER: REQUESTOR Name (f, mi., l): SSN: Address
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PPS STAFF NAME: DATE: PHONE: EMAIL: PPS SUPERVISOR AUTHORIZATION: Supervisor or
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_4000_Forms/PPS4007.doc
if multiple student names appear on an e-mail message to be filed in the service record
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of contact would be phone call to the student, email to the student (if appropriate), and/or
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https://www.dcf.ks.gov/services/RS/Documents/Policy/SEC_7-8.docx
Child: minor under the age of 18
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Consul/consular officer: foreign government official
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Affairs through http://travel.state.gov/consularnotification or email at consnot@state.gov
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_5E.doc
State Zip: Date Sent to Custodian: Email address: The custodianship subsidy is to be
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Please answer the following questions and return to the designated office within thirty (30
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6165.doc
Part 2 Service and Payment Authorizations
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Rehabilitation Services (RS) must employ methods of
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1. Staff need to call/email to speak with the provider/vendor to let them know and ensure
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https://www.dcf.ks.gov/services/RS/Documents/Policy/SEC_6-2.docx