Name of person completing this form
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E-mail address
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Child’s Name: MATCH ID: Facts Client ID
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Is this child a member of a sibling group
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Move child to the private site (child will not
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5315.doc
Please email this enrollment form along with a copy of your child support order, income
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If yes, how would you like to receive the surveys: ☐Text ☐Email ☐Both, text & email
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https://www.dcf.ks.gov/services/CSS/Documents/CSS Enrollment Form.pdfView duplicates
When DCF is no longer the Representative Payee of a foster child’s benefit, the worker shall
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Accountant at bottom of Worksheet and e-mail Worksheet(s) with attachments (if applicable
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5927B_Instr.docx
Instructions: The Site Visit Tool is to be completed at in-person site visits for initial reviews, 90-day reviews and annual reviews
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This site visit tool will score the policy and
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_8000_Forms/PPS8400F.doc
Prevention and Protection Services KIPS Investigation ID: PPS 10600
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to KGP Telephone 785-587-8555 Worker E-mail address Telephone Number I
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Yes No If yes, what is
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_10000_Forms/PPS10600.doc
State of Kansas PPS 5927A Instructions
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Department for Children and Families Rev. October 2019
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Accountant at bottom of Worksheet and e-mail Worksheet with attachments (if applicable) to
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5927A_Instr.docx
Quality Residential Treatment Program (QRTP) Site Visit Tool
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Instructions: The Site Visit Tool is to be completed at in-person site visits for initial reviews, 90-day reviews and
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_8000_Forms/PPS8400H.doc
Floor Topeka, Kansas 66603 Website: http://www.dcf.ks.gov Email: DCF.FCL@ks.gov
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Family Foster Home Renewal Application Checklist
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Submit the Following Documents with the
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 402 FFH Renewal Application.pdf
Inc. 731 N Water Suite 2 Wichita, KS 67203 Phone: 316-267-3825 Fax: 316-267-3843 E-Mail
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Wichita 122 N Millwood Wichita, KS 67203 Phone: 316-265-6011 Fax: 316-265-4022 E-Mail
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https://www.dcf.ks.gov/Agency/Testimony/Documents/2008/HB-2879_AttachmentMap.pdf
Non-KORA Agency Records Request Form * REQUESTOR INFORMATION
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Requestor Work Email
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Please provide the following information on the person whose Kansas DCF case history is being
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https://www.dcf.ks.gov/Records/Documents/Non-KORA-Agency-RecordsRequestForm.pdf