New Match Intake

If you are interested in a parent match, please complete and submit the information below. Once your form is submitted, a Regional Coordinator will contact you by phone to personally explain our free and confidential services. This call helps to ensure the most appropriate peer supporter match based on your needs. Please be aware that the matching process will not begin until a Parent to Parent of PA Regional Coordinator has spoken to you directly.

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Contact Details

By submitting this form you are agreeing to allow your information to be released to the Parent to Parent of PA program for further contact.