PPM Current Forms and Appendices
July 2008
wpd Word Perfect doc Microsoft Word pdf Adobe Acrobat SPA Spanish
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 |