Parents Taking Action Together Support Group
Please join us the second Wednesday of each month for this parent education support group—Parents Taking Action Together. Facilitated by behavioral health providers, family navigators, and other community partners, this group is for any parent with child(ren) who have behavioral and mental health needs, including those involved in the juvenile justice system. Our purpose is to offer support to parents in today’s world.
Full Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
Format: (000) 000-0000.
Number of people attending
*
Tell us a little more about your children.
*
Rows
Age
Your Relationship to Child
Child #1
0-11 months
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
11 years
12 years
13 years
14 years
15 years
16 years
17 years
18 years
19 years
20 years or older
Parent
Grandparent
Guardian
Foster Parent
Other
Child #2
0-11 months
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
11 years
12 years
13 years
14 years
15 years
16 years
17 years
18 years
19 years
20 years or older
Parent
Grandparent
Guardian
Foster Parent
Other
Child #3
0-11 months
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
11 years
12 years
13 years
14 years
15 years
16 years
17 years
18 years
19 years
20 years or older
Parent
Grandparent
Guardian
Foster Parent
Other
Child #4
0-11 months
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
11 years
12 years
13 years
14 years
15 years
16 years
17 years
18 years
19 years
20 years or older
Parent
Grandparent
Guardian
Foster Parent
Other
Child #5
0-11 months
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
11 years
12 years
13 years
14 years
15 years
16 years
17 years
18 years
19 years
20 years or older
Parent
Grandparent
Guardian
Foster Parent
Other
Child #6
0-11 months
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
11 years
12 years
13 years
14 years
15 years
16 years
17 years
18 years
19 years
20 years or older
Parent
Grandparent
Guardian
Foster Parent
Other
Child #7
0-11 months
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
11 years
12 years
13 years
14 years
15 years
16 years
17 years
18 years
19 years
20 years or older
Parent
Grandparent
Guardian
Foster Parent
Other
Child #8
0-11 months
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
11 years
12 years
13 years
14 years
15 years
16 years
17 years
18 years
19 years
20 years or older
Parent
Grandparent
Guardian
Foster Parent
Other
Do you have any questions or topics you'd like us to address?
Would you like to receive emails about upcoming behavioral health learning opportunities?
*
Yes
No
How did you hear about this event?
Friend, Family, or Colleague
Employer
School
Social Media
Healthcare Provider
Other
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