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State of Kansas Department for Children and Families Prevention and Protection Services PPS 10120 REV. 7/2016 Notification to Law Enforcement APS reports Please type or print Involved Adult: To: Date
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How to fill out Kansas Adult Protective Services:

01
Gather necessary documents: Before filling out the Kansas Adult Protective Services form, make sure you have all the required documents handy. This may include personal identification documents, medical records, and any relevant legal documents.
02
Access the form: Visit the official website of Kansas Adult Protective Services or contact your local social services agency to obtain the correct form. The form may also be available in various languages, so ensure you have the appropriate version.
03
Provide accurate personal information: Start by filling out your personal information accurately. This includes your full name, date of birth, address, phone number, and other relevant contact details.
04
Specify the purpose: Indicate the reason for filling out the Kansas Adult Protective Services form. This could be if you are reporting abuse or neglect, require assistance for an elderly or disabled individual, or have concerns about someone's safety.
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Detail the incident or situation: In this section, provide a clear and concise description of the incident or situation that prompted you to fill out the form. Include relevant dates, locations, and any supporting evidence you may have, such as photographs or witness statements.
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Identify the individuals involved: Clearly state the names and relationship of the individuals involved, including the alleged perpetrator if applicable. Provide as much information as possible to help investigators understand the situation.
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List any additional concerns: If you have any other concerns or observations related to the incident or situation, mention them in this section. This could include signs of physical or emotional abuse, financial exploitation, or any other relevant details.
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Sign and submit the form: Make sure to review the form thoroughly before signing and submitting it. Ensure all the provided information is accurate and complete. If you have any questions or need assistance, consult the instructions or contact the relevant agency for guidance.

Who needs Kansas Adult Protective Services?

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Elderly individuals: Kansas Adult Protective Services is essential for older adults who are at risk of abuse, neglect, or exploitation. This includes those living in nursing homes, assisted living facilities, or their own homes.
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Adults with disabilities: Adults with disabilities, including physical, mental, or developmental disabilities, may require the assistance of Kansas Adult Protective Services if they are facing abuse, neglect, or exploitation.
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Concerned community members: Anyone who suspects or witnesses abuse, neglect, or exploitation of an elderly or disabled adult can and should report their concerns to Kansas Adult Protective Services. It is important to be vigilant and help protect vulnerable individuals in the community.
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Kansas Adult Protective Services is a government agency that aims to protect vulnerable adults who are unable to protect themselves from abuse, neglect, or exploitation.
Any person who has reason to believe that an adult is being abused, neglected, or exploited is required to file a report with Kansas Adult Protective Services.
To fill out Kansas Adult Protective Services report, you need to provide detailed information about the adult at risk, the nature of the abuse or neglect, and any supporting evidence.
The purpose of Kansas Adult Protective Services is to investigate reports of abuse, neglect, or exploitation of vulnerable adults and provide services to ensure their safety and well-being.
Information such as the name and address of the adult at risk, details of the alleged abuse or neglect, and any relevant background information must be reported on Kansas Adult Protective Services.
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2016 Kansas APS DCF Atty PPS DOB Fiduciary mandated hrs Dept Allegation Notification Prevention reopened exploitation coordinating accordance summary PERPETRATOR neglect Apt statute

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