Consumer’s work skills, conditions, preferences and interest
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(Recommend other pertinent consumer information be shared with the provider to assist
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Provider Contact Name: Phone: Email
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https://www.dcf.ks.gov/services/RS/Documents/service_descriptions/Contracts/Section 11 Part-24_Service_referral_form.doc
02-17 INSTRUCTIONS: Complete this form and email to DCF.EBTMAIL@ks.gov within 20 days of
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Retain original in the case file
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TYPE OF ACTIVITY (CHECK ONE) ADD CHANGE DELETE 1. NAME
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-524_FS_Disqualification02-17.docView duplicates
Client is being referred to the Workforce Center to register for a KANSASWORKS Plus account and to enroll in Career Ready 101
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Client is scheduled to visit the Workforce Center by
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EMAIL
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-4418_CR101_Referral_Turn_Around_Form_01-21.docView duplicates
Food Assistance Replacement During Household Disasters
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Email: EBTMAIL (DCF.EBTMAIL@ks.gov
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When food purchased with food assistance benefits is destroyed in a disaster (definition below
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-3143_fs_disaster_form_08-21.docxView duplicates
The PPS 3059 serves as the formal transition plan document required by Federal and State policy, in accordance with the Family First Prevention Services Act of 2018
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It is to be used as
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3059_Instr.doc
Department for Children and Families 07/2023
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Prevention and Protection Services Page 1 of 2
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Section I: The Representative Gail Finney Memorial Foster Care Bill of Rights Part of and
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5138.docx
DEPARTMENT FOR CHILDREN AND FAMILIES 05-22
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Email
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DCF is trying to determine if the presence of is required
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at home because has a medically determined condition
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-4310-A-NEEDFORCARE_05-22.docxView duplicates
DEPARTMENT FOR CHILDREN AND FAMILIES 05-22
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Email
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DCF is trying to determine if the presence of is required
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at home because has a medically determined condition
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-4310-C-NEEDFORCARE_05-22.docxView duplicates
Introduction and purpose of the RFI 3
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How to deliver the answer 6
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Marking Records Exempt From Disclosure (Protected, Confidential, or Proprietary) 7
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The facility will be fully furnished
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https://www.dcf.ks.gov/Agency/Operations/Documents/RFI Olathe Facility.doc
STATE OF KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES
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*Type Contact: HI (Home Interview); OI (Office Interview); SI (School
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_1000_Forms/PPS1010.doc