Email Address
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SECTION IV: Other Individuals able to provide information on child’s functioning (IE: Foster Parents, School
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Once this form is complete please email to: QRTP@healthsrc.org
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5115.docx
The PPS 4200 Family Preservation Referral shall be completed for each family referred to the
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CPS Specialist’s Email: Enter the email address where the CPS Specialist can be contacted
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_4000_Forms/PPS4200_Instr.docx
DCF Grant Request for Proposal (RFP
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DCF – Prevention and Protection Services (PPS
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Kansas Department for Children and Families
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DCF Pre-Award Manager via e-mail at dcf.grants@ks.gov
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https://www.dcf.ks.gov/Agency/Operations/Documents/WKD GRANT RFP.doc
DCF Grant Request for Proposal (RFP
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Supplemental Nutrition Assistance Program (SNAP) Food Assistance Outreach
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DCF Pre-Award Manager via e-mail at dcf.grants@ks.gov
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https://www.dcf.ks.gov/Agency/Operations/Documents/SNAP Outreach Grant Request for Proposal.docx
Contact name/number(s) for family
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CPS Specialist’s Email
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☐ No ☐ Yes (If yes, list name
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Dates/Times CPS Specialist/Family Preservation Liaison is available for Initial Family Meeting
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_4000_Forms/PPS4200.docx
Department for Children and Families Prevention and Protection Services
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Initial Team Decision MakingTM (TDM) Protocol
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I. Definition and Purpose of TDM
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A. Preparing to Lead the Discussion
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_0D.docx
All items are attached to an email and sent to corresponding regional email, including “County.SOUL FAMILY SUBSIDY.Youth
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Follow instructions prompted within email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6300.docx
Encrypted CD, encrypted flash drives, encrypted email (email address), fax (fax Number) or mail
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If you have any questions or concerns, you may contact me at (phone number/email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_10000_Forms/PPS10209.docx
Address: City/State/Zip Phone #: Email: Vendor Name: Vendor ID: Address: City/State/Zip Phone #: Email
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Subsidy Amount and Month Authorized: Month/Year
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_7000_Forms/PPS7210.docView duplicates
shall be sent to the DCF NYTD email and DCF Independent Living regional email, where the youth will be located or has
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3059C_Instr.doc