SECTION I: Identifying Information – Completed by CPS/FC Liaison/IL Coordinator
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Date of Intake Assignment: Click or tap to enter a date
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Family First Regional Email (check one below
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_4000_Forms/PPS4311.docx
Home > Agency Information > Organizational Health and Development
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at 785-296-4327 or send an email to DCF.LMSSupport@ks.gov.
DCF Online Training Center
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https://www.dcf.ks.gov/Agency/SD
Email
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Regulatory Compliance and Quality Assurance Administrator, Supervises the FCL Admin staff, Racheal Sain
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Supervises Regional Supervisors and Training Specialist
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/Licensing Staff Contact List.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
Educational Enrollment Information for School Placement Form
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Mental Health Provider Email Address
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Placement Email
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School Building Contact Email
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ESSA School District Point of Contact Email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5254.docxView duplicates
Department for Children and Families REV. Jul
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Email/Phone
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Alternative Email or Social Media Contact
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If you have any NYTD questions, please email: KS.NYTD@dcf.ks.gov
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3059C.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
Department for Children and Families REV. Jul 2025
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This plan shall be collaboratively created by the youth or young adult, the case management team, and
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Email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3059A.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
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