Prevention and Protection Services PPS CLIENT PURCHASE AGREEMENT
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PPS Worker: Fax: Region: Co: e-mail: @ks.gov Program: Client Information Client
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_2000_Forms/PPS2833.doc
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
Disability Determination Referral to Kansas Legal Services Child age birth to 17 years Child/Youth – age 18 to 23 years Child’s Name: DCF Case Number: SSN Street Address
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_5U.doc
The Child Care Exception Payment (CCEP) Program is a supplement to Foster Care Child Care (FCCC) funding
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FCCC funding must be used first where applicable
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E-mail of Childcare Provider
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/5258B.docxView duplicates
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
Child Care Providers: The Child Care Exception Payment (CCEP) Program is a supplement to Foster Care Child Care (FCCC) funding
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You must initial each box on
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E-mail of Childcare Provider
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https://www.dcf.ks.gov/services/PPS/Documents/FY2023DataReports/Public Website Documents/5258b_CCEPP CCProvAgreement.docx
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
Kansas Department of Corrections - Juvenile Services Division
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On behalf of the minor child
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orally, in paper documents, or electronically by e-mail, fax machine, or data entry into the
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_5Q.doc