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• *Indicates forms to be submitted to KDHE (Additional documentation is required)

  *CCL 752  Application  11/2009
  *CCL 755  Approval for Locked Entrances, Exits  11/2009
  *CCL 002  Request for KBI/SRS Registry Check  08/2011 en EspañolCL 002

  Supplemental Forms for the PRTF
  CCL 002  Request for KBI/SRS Registry Check  08/2011 en EspañolCL 002
  CCL 009  Health Assessment, 16 & Older  08/2011 en EspañolCL 009
  CCL 053  Medical Record for Children in 24 hour Facilities  09/2003
  CCL 054  Continuous Dental Record  2002