Parenting Support Interest Form

Parenting Support Interest Form

This form is for caregivers who are interested in getting connected to a Triple P provider for more tailored parenting support. Please fill out the following information so we can help match you with a Triple P provider in your area. A WNC Triple P team member will follow up once your form is submitted.

Name*

Email Address*

What Western North Carolina county do you live in?*

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What type of support are you most interested in?*

Please note that there are many different levels and ways you can receive Triple P parenting support. Our team will follow up and make sure you are matched with the model that best suits your unique needs.

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How old is your child or children?*

Are you a parent of a child with a disability?*

Triple P has parenting support programs specific to caregivers of pre-adolescent children with intellectual or/and physical disabilities.

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Do you have health insurance?*

We have a large network of agencies in Westen North Carolina that deliver Triple P. Each has its own criteria for taking referrals. Some agencies require insurance and some do not.

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Provider

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