PPM Current Forms and Appendices

July 2008

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Note: If you receive an error message when opening a form or appendix: right click while curser is on the form number, select "save target as", save form/appendix and select to open.

CFS 0300 wpd NOTICE OF INTENT TO DISCLOSE RECORD
CFS 0300 doc NOTICE OF INTENT TO DISCLOSE RECORD
  CFS 0500 doc   KCDRB CASE INFORMATION SUMMARY
  CFS 0501  wpd   CHILD DEATH OR NEAR DEATH PRELIMINARY CASE REVIEW PROTOCOL
  CFS 0501  doc   CHILD DEATH OR NEAR DEATH PRELIMINARY CASE REVIEW PROTOCOL

  CFS 1000  wpd

  FACE SHEET

  CFS 1000 doc   FACE SHEET

  CFS 1000 Inst  wpd

  COMPLETING THE FACE SHEET, FORM CFS 1000

  CFS 1000 Inst  doc   COMPLETING THE FACE SHEET, FORM CFS 1000

  CFS 1001  wpd

  REPORT/REQUEST FOR SERVICES

  CFS 1001  doc   REPORT/REQUEST FOR SERVICES

CFS 1001 Inst  wpd

  COMPLETING THE REPORT/REQUEST FOR SERVICES/REPORT SCREEN, FORM

 

  CFS 1001 Inst  doc  COMPLETING THE REPORT/REQUEST FOR SERVICES/REPORT SCREEN, FORM

  CFS 1001A   wpd

SUMMARY OF RESULTS OF PRELIMINARY INQUIRY
  CFS 1001A  doc SUMMARY OF RESULTS OF PRELIMINARY INQUIRY

  CFS 1002      wpd

 RESPONSE DETERMINATION

  CFS 1002  doc  RESPONSE DETERMINATION

  CFS 1002 Inst     wpd

  COMPLETING THE RESPONSE DETERMINATION, FORM CFS 1002

 CFS 1002 Inst  doc  COMPLETING THE RESPONSE DETERMINATION, FORM CFS 1002

  CFS 1003  wpd

  REQUEST TO INTERVIEW A CHILD AT SCHOOL

  CFS 1003  doc   REQUEST TO INTERVIEW A CHILD AT SCHOOL

  CFS 1004   wpd

  AGENCY RESPONSE (FACILITY AND THIRD PARTY RESPONSE)

  CFS 1004  doc   AGENCY RESPONSE (FACILITY AND THIRD PARTY RESPONSE)

  CFS 1004 Inst  wpd

  COMPLETING THE AGENCY RESPONSE, FORM CFS 1004 FOR FACILITY AND      THIRD PARTY REPORTS

  CFS 1004 Inst  doc   COMPLETING THE AGENCY RESPONSE, FORM CFS 1004 FOR FACILITY AND      THIRD PARTY REPORTS

  CFS 1005   wpd

  NOTICE OF ACTION TO REPORTERS OF SUSPECTED CHILD ABUSE OR      NEGLECT

  CFS 1005  doc  NOTICE OF ACTION TO REPORTERS OF SUSPECTED CHILD ABUSE OR      NEGLECT

  CFS 1006   wpd

  REPORT OF UNEXCUSED SCHOOL ABSENCES

  CFS 1006  doc   REPORT OF UNEXCUSED SCHOOL ABSENCES

  CFS 1006 Inst   wpd

  INSTRUCTIONS FOR CFS 1006, REPORT OF UNEXCUSED SCHOOL ABSENCES

  CFS 1006 Inst  doc   INSTRUCTIONS FOR CFS 1006, REPORT OF UNEXCUSED SCHOOL ABSENCES

  CFS 1007   wpd

  NOTICE OF CHILD INTERVIEW

  CFS 1007 doc   NOTICE OF CHILD INTERVIEW
 CFS 1007 wpd SPA   NOTICE OF CHILD INTERVIEW
 CFS 1007 doc SPA   NOTICE OF CHILD INTERVIEW
 CFS 1008     wpd   NOTICE OF INVESTIGATION
 CFS 1008  doc   NOTICE OF INVESTIGATION
CFS 1011  doc CENTRAL REGISTRY RELEASE OF INFORMATION
CFS 2003    wpd FAMILY BASED SAFETY PLAN
CFS 2003  doc FAMILY BASED SAFETY PLAN

CFS 2003 Inst  wpd

COMPLETING THE CFS 2003 FAMILY BASED SAFETY PLAN

CFS 2003 Inst  doc COMPLETING THE CFS 2003 FAMILY BASED SAFETY PLAN
CFS 2003   wpd SPA FAMILY BASED SAFETY PLAN
CFS 2003   doc SPA FAMILY BASED SAFETY PLAN
CFS 2003   pdf SPA FAMILY BASED SAFETY PLAN

CFS 2004     wpd

YOUTH NEEDS ASSESSMENT

CFS 2004  doc YOUTH NEEDS ASSESSMENT

CFS 2004 Inst  wpd

INSTRUCTIONS FOR YOUTH NEEDS ASSESSMENT

CFS 2004 Inst  doc INSTRUCTIONS FOR YOUTH NEEDS ASSESSMENT

CFS 2010         wpd

BROCHURE --WHAT YOU NEED TO KNOW ABOUT INVESTIGATIONS OF CHILD ABUSE OR NEGLECT

CFS 2010   doc BROCHURE --WHAT YOU NEED TO KNOW ABOUT INVESTIGATIONS OF CHILD ABUSE OR NEGLECT
CFS 2010  doc SPA BROCHURE--WHAT YOU NEED TO KNOW ABOUT INVESTIGATIONS OF CHILD ABUSE OR NEGLECT

CFS 2011       wpd

CASE FINDINGS (CHILD ABUSE AND NEGLECT REPORT)

CFS 2011    doc CASE FINDINGS (CHILD ABUSE AND NEGLECT REPORT)

CFS 2011 Inst  wpd

COMPLETING THE CASE FINDINGS, FORM CFS 2011

CFS 2011 Inst doc COMPLETING THE CASE FINDINGS, FORM CFS 2011
CFS 2012  doc KANSAS DEPARTMENT OF SOCIAL AND REHABILITATION SERVICES NOTICE OF DEPARTMENT FINDINGS-FAMILY REPORTS
CFS 2012 Inst  wpd INSTRUCTIONS FOR KANSAS DEPARTMENT OF SOCIAL AND REHABILITATION SERVICES NOTICE OF DEPARTMENT FINDINGS-FAMILY REPORT
CFS 2012 Inst  doc INSTRUCTIONS FOR KANSAS DEPARTMENT OF SOCIAL AND REHABILITATION SERVICES NOTICE OF DEPARTMENT FINDINGS-FAMILY REPORT
CFS 2012   doc SPA KANSAS DEPARTMENT OF SOCIAL AND REHABILITATION SERVICES NOTICE OF DEPARTMENT FINDINGS-FAMILY REPORTS
CFS 2012   pdf  SPA KANSAS DEPARTMENT OF SOCIAL AND REHABILITATION SERVICES NOTICE OF DEPARTMENT FINDING-FAMILY REPORTS
CFS 2012 pdf LAO KANSAS DEPARTMENT OF SOCIAL AND REHABILITATION SERVICES NOTICE OF DEPARTMENT FINDING-FAMILY REPORTS
CFS 2013  doc NOTICE OF DEPARTMENT FINDINGS-FACILITY REPORTS
CFS 2013  doc SPA NOTICE OF DEPARTMENT FINDINGS-FACILITY REPORTS

CFS 2014A    wpd

CORRECTIVE ACTION PLAN: REPORTS INVOLVING FACILITIES

CFS 2014A   doc CORRECTIVE ACTION PLAN: REPORTS INVOLVING FACILITIES

CFS 2015     wpd

REFERRAL TO INFANT AND TODDLER SERVICES

CFS 2015   doc REFERRAL TO INFANT AND TODDLER SERVICES
CFS 2016   doc COMPLAINT REPORT FACILITY SUBJECT TO REGULATION BY KDHE
CFS 2016 Inst  doc COMPLETING THE COMPLAINT REPORT: FACILITY SUBJECT TO REGULATION BY KDHE, FORM CFS 2016
CFS 2017  doc FAX COVER SHEET TO ATTORNEY GENERAL

CFS 2018     wpd

REVIEW OF REPEAT MALTREATMENT IN SIX MONTHS

CFS 2018  doc REVIEW OF REPEAT MALTREATMENT IN SIX MONTHS
CFS 2020     wpd FAMILY PRESERVATION REFERRAL AND TRANSMITTAL SHEET
CFS 2020  doc FAMILY PRESERVATION REFERRAL AND TRANSMITTAL SHEET

CFS 2030A       wpd

AGENCY RESPONSE (FAMILY BASED ASSESSMENT ONLY)

CFS 2030A  doc AGENCY RESPONSE (FAMILY BASED ASSESSMENT ONLY)

CFS 2030A Inst wpd

COMPLETING THE AGENCY RESPONSE, FORM CFS 2030A

CFS 2030A Inst doc COMPLETING THE AGENCY RESPONSE, FORM CFS 2030A

CFS 2030B     wpd  

SAFETY ASSESSMENT

CFS 2030B  doc SAFETY ASSESSMENT

CFS 2030B Inst wpd

COMPLETING THE SAFETY ASSESSMENT, CFS 2030B

CFS 2030B Inst doc COMPLETING THE SAFETY ASSESSMENT, CFS 2030B

CFS 2030C      wpd

RISK ASSESSMENT  (short form)

CFS 2030C  doc RISK ASSESSMENT  (short form)

CFS 2030C Inst wpd

COMPLETING THE RISK ASSESSMENT (Short), FORM CFS 2030C

CFS 2030C inst doc COMPLETING THE RISK ASSESSMENT (Short), FORM CFS 2030C

CFS 2030D    wpd

RISK ASSESSMENT

CFS 2030D  doc RISK ASSESSMENT

CFS 2030D Inst wpd

COMPLETING THE RISK ASSESSMENT, FORM CFS 2030D

CFS 2030D Inst doc COMPLETING THE RISK ASSESSMENT, FORM CFS 2030D

CFS 2030 E    wpd

CHILD IN NEED OF CARE- NON ABUSE OR NEGLECT ASSESSMENT

CFS 2030E   doc CHILD IN NEED OF CARE- NON ABUSE OR NEGLECT ASSESSMENT

CFS-2030E Inst wpd

COMPLETING THE CINC/NAN ASSESSMENT, FORM CFS 2030E

CFS 2030E Inst  doc COMPLETING THE CINC/NAN ASSESSMENT, FORM CFS 2030E

CFS 2030-F   wpd

FAMILY BASED ASSESSMENT SUMMARY

CFS 2030F   doc FAMILY BASED ASSESSMENT SUMMARY

CFS 2030F Inst wpd

COMPLETING THE FAMILY BASED ASSESSMENT SUMMARY, CFS 2030F

CFS 2030F Inst doc COMPLETING THE FAMILY BASED ASSESSMENT SUMMARY, CFS 2030F
CFS 3003        wpd COURT REPORT
CFS 3003       doc COURT REPORT
CFS 3011        wpd INTERACTION/ VISITATION/CONTACT LOG
CFS 3011    doc INTERACTION/ VISITATION/CONTACT LOG
CFS 3020        wpd NOTIFICATION OF ADOPTION CASE  PLAN
CFS 3020        doc NOTIFICATION OF ADOPTION CASE PLAN
CFS 3020 Inst  wpd NOTIFICATION OF ADOPTION CASE PLAN INSTRUCTIONS
CFS 3020 Inst   doc NOTIFICATION OF ADOPTION CASE PLAN INSTRUCTIONS
CFS 3022    wpd REQUEST FOR ADOPTION SERVICES
CFS 3022         doc REQUEST FOR ADOPTION SERVICES
CFS 3022 Inst wpd INITIAL REFERRAL TO ADOPTION CONTRACTOR INSTRUCTIONS
CFS 3022 Inst  doc INITIAL REFERRAL TO ADOPTION CONTRACTOR INSTRUCTIONS
CFS 3030         wpd INITIAL REFERRAL TO OUT OF HOME PLACEMENT PROVIDER FOR CHILD IN SRS CUSTODY
CFS 3030   doc INITIAL REFERRAL TO OUT OF HOME PLACEMENT PROVIDER FOR CHILD IN SRS CUSTODY
CFS 3030 Inst wpd INITIAL REFERRAL TO OUT OF HOME PLACEMENT PROVIDER FOR CHILD IN SRS CUSTODY INSTRUCTIONS
CFS 3030 Inst  doc INITIAL REFERRAL TO OUT OF HOME PLACEMENT PROVIDER FOR CHILD IN SRS CUSTODY INSTRUCTIONS
CFS 3035     wpd ACKNOWLEDGEMENT OF PARENTAL OBLIGATION
CFS 3035   doc ACKNOWLEDGEMENT OF PARENTAL OBLIGATION
CFS 3035   wpd SPA ACKNOWLEDGEMENT OF PARENTAL OBLIGATION
CFS 3035  doc  SPA ACKNOWLEDGEMENT OF PARENTAL OBLIGATION
CFS 3037        wpd REFERRAL FOR EDUCATION ADVOCATE
CFS 3037       doc REFERRAL FOR EDUCATION ADVOCATE
CFS 3038    wpd AUTHORIZATION FOR TANF/EA SERVICES AND ASSISTANCE
CFS 3038   doc AUTHORIZATION FOR TANF/EA SERVICES AND ASSISTANCE
CFS 3040   doc REQUEST FOR 30 DAY TRIAL HOME PLACEMENT
CFS 3049  doc INTRODUCTION AND PARENT'S GUIDE TO CASE PLANNING CONFERENCES
CFS  3050      doc GENERAL INSTRUCTIONS
CFS 3050A     wpd PERMANENCY PLAN
CFS 3050A      doc PERMANENCY PLAN
CFS  3050A Inst wpd PERMANENCY PLAN INSTRUCTIONS
CFS 3050 A Inst doc PERMANENCY PLAN INSTRUCTIONS
CFS 3050A doc SPA PERMANENCY  PLAN
CFS  3050B   wpd PERMANENCY OBJECTIVES
CFS 3050B       doc PERMANENCY OBJECTIVES
CFS  3050B Inst wpd PERMANENCY OBJECTIVES  INSTRUCTIONS
CFS 3050B Inst  doc PERMANENCY OBJECTIVES INSTRUCTIONS
CFS 3050B doc SPA PERMANENCY OBJECTIVES
CFS  3050C    wpd PARTICIPANTS'  SIGNATURES/DATE
CFS 3050C      doc PARTICIPANTS' SIGNATURE/DATE
CFS  3050C Inst wpd PARTICIPANT SIGNATURES INSTRUCTIONS
CFS 3050C Inst  doc PARTICIPANT SIGNATURES INSTURCTIONS
CFS 3050C docSPA PARTICIPANTS' SIGNATURE/DATE
CFS 3050D     doc CHILD AND YOUTH PLAN
CFS 3050D Inst  doc CHILD AND YOUTH PLAN INSTRUCTIONS
CFS 3050D docSPA CHILD AND YOUTH PLAN
CFS 3050F-1    wpd    PARENT CHILD INTERACTION PLAN
CFS 3050F-1      doc PARENT CHILD INTERACTION PLAN
CFS 3050F-1 Inst wpd PARENT CHILD INTERACTION PLAN INSTRUCTIONS
CFS 3050F-1 Inst  doc PARENT CHILD INTERACTION PLAN INSTRUCTIONS
CFS 3050F-1 doc SPA PARENT CHILD INTERACTION PLAN
CFS 3050F-2   wpd VISITATION PLAN
CFS 3050F-2    doc VISITATION PLAN
CFS 3050F-2 Inst wpd VISITATION PLAN INSTRUCTIONS
CFS 3050F-2 Inst  doc VISITATION PLAN INSTRUCTIONS
CFS 3050F-2 wdoc SPA VISITATION PLAN
CFS 3050G  wpd PERMANENCY PLAN REVIEW
CFS 3050G  doc PERMANENCY PLAN REVIEW
CFS 3050G Inst wpd PERMANENCY PLAN REVIEW INSTRUCTIONS
CFS 3050G Inst  doc PERMANENCY PLAN REVIEW INSTRUCTIONS
CFS 3050G  doc SPA PERMANENCY PLAN REVIEW
CFS 3060     wpd DESK REVIEW
CFS 3060     doc DESK REVIEW
CFS 4000   doc BROCHURE-FAMILY PRESERVATION SERVICES KEEPING FAMILIES TOGETHER
CFS 4000  pdf BROCHURE-FAMILY PRESERVATION SERVICES KEEPING FAMILIES TOGETHER
CFS 4000 pdf SPA BROCHURE-FAMILY PRESERVATION SERVICES KEEPING FAMILIES TOGETHER
CFS 4001    wpd AUTHORIZATION FOR RELEASE OF CONFIDENTIAL INFORMATION
CFS 4001    doc AUTHORIZATION FOR RELEASE OF CONFIDENTIAL INFORMATION
CFS 4001  wpd SPA AUTHORIZATION FOR RELEASE OF CONFIDENTIAL INFORMATION
CFS 4001  doc SPA AUTHORIZATION FOR RELEASE OF CONFIDENTIAL INFORMATION
CFS 4002  doc FAMILY HANDBOOK
CFS 4003       wpd AUTHORIZATION TO DISCLOSURE INFORMATION, INCLUDING CHILD(REN)'S INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION
CFS 4003     doc AUTHORIZATION TO DISCLOSURE INFORMATION, INCLUDING CHILD(REN)'S INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION
CFS 4003  wpd SPA AUTHORIZATION TO DISCLOSURE INFORMATION, INCLUDING CHILD(REN)'S INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION
CFS 4003  doc SPA AUTHORIZATION TO DISCLOSURE INFORMATION, INCLUDING CHILD(REN)'S INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION
CFS 4003  pdf SPA AUTHORIZATION TO DISCLOSURE INFORMATION, INCLUDING CHILD(REN)'S INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION
CFS 4010     wpd ICAMA FORM 6.01*NOTICE OF MEDICAID ELIGIBILITY/CASE ACTIVATION