Children Services

Supported Family Living - Forms

Supported Family Living Forms are available below. If you have questions regarding these forms or about Support Family Living please contact Lakemary's Supported Family Living Coordinator at (913) 671-1800 ext. 207 or send us an email.

Potential Supported Family Living Provider Families:

• Supported Family Living Provider Application
• KDHE Provider Application/Renewal

Current Supported Family Living Provider Forms:

• KDHE Provider Application/Renewal
• Timesheets
• Dental Record
• Health Assessment for ages 16+
• Health Assessment for own children
• KBI Abuse Background Check
• Mechanical Safety Check
• Critical Incident Form
• Fire & Tornado Drills
• Behavior Tracking Guidelines
• Behavior Data Collection
• Medication Logs
• Positive Discipline Form