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.docxView duplicates
RELINQUISHMENT OF MINOR CHILD TO AGENCY
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NOTICE TO PARENT: This is an important legal document and by signing it you are permanently giving up all custody and other parental rights to
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_5J.docxView duplicates
OR DCF/Prevention and Protection Services
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Return to: Prevention and Protection Services
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Note: This form is to be used by adult (18+) adoptees, whom adoption finalized
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Your email address
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_0000_Forms/PPS0340.docxView duplicates
Return to: Prevention and Protection Services
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Note: This form is to be used for contact with adult (18+) adoptees, whom adoption finalized in Kansas
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Your Email
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You must be named in the
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_0000_Forms/PPS0335.docxView duplicates
Waiver and Privacy Agreement
Send an email to DCF.FPTopeka@ks.gov – with the Date of
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completed DCF Required paperwork to the email – (Waiver / FP-1020)
Return to Office of
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https://www.dcf.ks.gov/Agency/Operations/Pages/Fingerprint--Srvices.aspx
State of Kansas
Department for Children and Families
Prevention and Protection Services
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The adoption assistance case shall be reviewed on
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Parent 1 Email address
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Parent 2 Email address
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6135.docxView duplicates
Names of Children in the family
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Please print to indicate your attendance
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Address, email and phone numbers are optional
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This information is used to include you in any future meetings
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_0M.docView duplicates
Department for Children and Families REV. Jan. 25
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Return to: DCF/Prevention and Protection Services
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Note: This form is to be used by adults (18+) who were
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Email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_0000_Forms/PPS0332.docxView duplicates
Return to: Prevention and Protection Services
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I hereby give my permission to the Kansas Department for Children and Families to release the information I have provided
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Your email address
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_0000_Forms/PPS0350.docx
Return to: DCF/Prevention and Protection Services
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Adult Adoptee Requesting Copy of Adoption Record
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Note: This form is to be used by adult (18+) adoptees, whom adoption finalized in
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Email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_0000_Forms/PPS0330.docxView duplicates