Agency name Agency mailing address Email address: Will return via Encrypted email unless marked otherwise
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Email: DCF.APSRegistry@ks.gov
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_10000_Forms/PPS10400.docx
Department for Children and Families REV. July 2022
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Do you have a safe place to
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for keeping a schedule, setting up an e-mail, and communicating in a professional manner
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3059.docx
Your Current Name: Your Telephone: Your Street Address: Your City/State/Zip: Your
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your identifying information (name, address, email address and/or telephone numbers), do not
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_0000_Forms/PPS0330.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
Attention Referral Agency: The Kansas Department for Children and Families (DCF) is providing this referral in accordance with K.S.A. 38 2290
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Per K.S.A. 38-2290, upon DCF's receipt
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EMAIL
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_2000_Forms/PPS2014_B.docx
Email
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Kimberly Klein,
Assessment and Prevention Administrator
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Cheyenne, Rawlins, Sherman, Thomas, Sheridan, Wallace, Logan, Phillips, Smith, Rooks, Osborne, Norton, Graham, Decatur
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https://www.dcf.ks.gov/services/PPS/Documents/NW PPS Intranet.docx
Email
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Dana Phillips,
Assessment and Prevention Administrator
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Brittany Martin,
Child Protection Services Supervisor
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Finney, Greeley, Wichita, Scott, Lane, Hamilton, Kearney
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https://www.dcf.ks.gov/services/PPS/Documents/SW PPS Intranet.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
County: Region: Address: Phone: Email address: Monitoring/Liaison worker
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Manager Name: Address: Phone Number: E-Mail Address: Finalization Date(s) of
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5110.doc
The PPS 3031 serves as a service plan for families to receive soon after a child or children
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a copy of the ISP (either via digitally/email or printed/hard copy); thus, it is imperative
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3031_Instr.docx