The PPS 3059 serves as the formal transition plan document required by Federal and State policy, in accordance with the Family First Prevention Services Act of 2018
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It is to be used as
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3059_Instr.doc
Presented by the Kansas Department for Children and Families
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Recognize when poverty is impacting a family
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Describe what to expect when calling the Kansas Protection Report Center
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https://www.dcf.ks.gov/services/PPS/Documents/Child-MandatedReporting/CPS_Mandated_Reporter_Training.pptx
Date: To: (facility CAO) (name of facility
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you have any questions, please contact: (APS Specialist) Telephone Number: E-Mail Address
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_10000_Forms/PPS10125.doc
Name of person completing this form
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E-mail address
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Please mark the box for the action to be taken on the family
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(If changes to composition (i.e. marriage, divorce, birth of a child, ect
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5325.doc
Department for Children and Families Prevention and Protection Services
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Provider’s Name: E-mail: Month: Address where care occurs: Year: List all
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/5828E.docx
Please email this enrollment form along with a copy of your child support order, income
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If yes, how would you like to receive the surveys: ☐Text ☐Email ☐Both, text & email
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https://www.dcf.ks.gov/services/CSS/Documents/CSS Enrollment Form.pdfView duplicates
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
This agreement is being executed on this date, prior to the finalization of the adoption, for the purpose of adoption assistance and/or medical services for the said child under the
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6130.doc
Name of person completing this form
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E-mail address
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Child’s Name: MATCH ID: Facts Client ID
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Is this child a member of a sibling group
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Move child to the private site (child will not
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5315.doc
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