KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES
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THIS Business Associate Agreement (the "Agreement") is made and entered into effective January 24, 2025 by and between the Secretary of the
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https://www.dcf.ks.gov/Agency/Operations/Documents/Business_Associate_Agreement-Template.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/PPS10211.docx
The adoption assistance case shall be reviewed on an annual basis
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This review serves as a tool
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City: State: Zip Code: Date Sent: Parent 1 Email address: Parent 2 Email address
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6135.doc
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.doc
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.docxView duplicates
Department for Children and Families REV. Jan-25
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What I would like people to
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Phone/Email
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Family Waiver Care: 785-296-9551 or email tawaiver@family-waiver-care.com
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3059B.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
Department for Children and Families REV. Jan-25
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KIPS Investigation ID: Click or tap here to
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Email: dataadmin@ksgprog.org & cc KGP Regional Liaison
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Email: Click or tap here to enter text
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_10000_Forms/PPS10600A.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.docView duplicates
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